Socioeconomic position is positively associated with blood pressure dipping among African-American adults: The Jackson heart study

DeMarc A. Hickson, Ana V. Diez Roux, Sharon B. Wyatt, Samson Y. Gebreab, Gbenga Ogedegbe, Daniel F. Sarpong, Herman A. Taylor, Marion R. Wofford

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Blunted nocturnal blood pressure (NBP) dipping is a significant predictor of cardiovascular events. Lower socioeconomic position (SEP) may be an important predictor of NBP dipping, especially in African Americans (AA). However, the determinants of NBP dipping are not fully understood. METHODS: The cross-sectional associations of individual and neighborhood SEP with NBP dipping, assessed by 24-h ambulatory BP monitoring, were examined among 837 AA adults (Mean age: 59.2 ± 10.7 years; 69.2% women), after adjustment for age, sex, hypertension status, body mass index (BMI), health behaviors, office, and 24-h systolic BP (SBP). RESULTS: The mean hourly SBP was consistently lower among participants in the highest category of individual income compared to those in the lowest category, and these differences were most pronounced during sleeping hours. The odds of NBP dipping (defined as <10% decline in the mean asleep SBP compared to the mean awake SBP) increased by 31% (95% confidence interval: 13-53%) and 18% (95% confidence interval: 0-39%) for each s.d. increase in income and years of education, respectively, after multivariable adjustment. CONCLUSIONS: NBP dipping is patterned by income and education in AA adults even after accounting for known risk factors. These results suggest that low SEP is a risk factor for insufficient NBP dipping in AA.

Original languageEnglish (US)
Pages (from-to)1015-1021
Number of pages7
JournalAmerican Journal of Hypertension
Volume24
Issue number9
DOIs
StatePublished - Sep 2011

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African Americans
Blood Pressure
Confidence Intervals
Education
Social Adjustment
Ambulatory Monitoring
Health Behavior
Body Mass Index
Hypertension

Keywords

  • ambulatory blood pressure monitoring
  • blood pressure
  • hypertension
  • Jackson Heart Study
  • nocturnal dipping
  • socioeconomic position
  • systole

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Socioeconomic position is positively associated with blood pressure dipping among African-American adults : The Jackson heart study. / Hickson, DeMarc A.; Diez Roux, Ana V.; Wyatt, Sharon B.; Gebreab, Samson Y.; Ogedegbe, Gbenga; Sarpong, Daniel F.; Taylor, Herman A.; Wofford, Marion R.

In: American Journal of Hypertension, Vol. 24, No. 9, 09.2011, p. 1015-1021.

Research output: Contribution to journalArticle

Hickson, DeMarc A. ; Diez Roux, Ana V. ; Wyatt, Sharon B. ; Gebreab, Samson Y. ; Ogedegbe, Gbenga ; Sarpong, Daniel F. ; Taylor, Herman A. ; Wofford, Marion R. / Socioeconomic position is positively associated with blood pressure dipping among African-American adults : The Jackson heart study. In: American Journal of Hypertension. 2011 ; Vol. 24, No. 9. pp. 1015-1021.
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abstract = "BACKGROUND: Blunted nocturnal blood pressure (NBP) dipping is a significant predictor of cardiovascular events. Lower socioeconomic position (SEP) may be an important predictor of NBP dipping, especially in African Americans (AA). However, the determinants of NBP dipping are not fully understood. METHODS: The cross-sectional associations of individual and neighborhood SEP with NBP dipping, assessed by 24-h ambulatory BP monitoring, were examined among 837 AA adults (Mean age: 59.2 ± 10.7 years; 69.2{\%} women), after adjustment for age, sex, hypertension status, body mass index (BMI), health behaviors, office, and 24-h systolic BP (SBP). RESULTS: The mean hourly SBP was consistently lower among participants in the highest category of individual income compared to those in the lowest category, and these differences were most pronounced during sleeping hours. The odds of NBP dipping (defined as <10{\%} decline in the mean asleep SBP compared to the mean awake SBP) increased by 31{\%} (95{\%} confidence interval: 13-53{\%}) and 18{\%} (95{\%} confidence interval: 0-39{\%}) for each s.d. increase in income and years of education, respectively, after multivariable adjustment. CONCLUSIONS: NBP dipping is patterned by income and education in AA adults even after accounting for known risk factors. These results suggest that low SEP is a risk factor for insufficient NBP dipping in AA.",
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