Clinic and ambulatory blood pressure in a population-based sample of African Americans: the Jackson Heart Study.

Academic Article

Abstract

  • Blood pressure (BP) can differ substantially when measured in the clinic versus outside of the clinic setting. Few population-based studies with ambulatory blood pressure monitoring (ABPM) include African Americans. We calculated the prevalence of clinic hypertension and ABPM phenotypes among 1016 participants in the population-based Jackson Heart Study, an exclusively African-American cohort. Mean daytime systolic BP was higher than mean clinic systolic BP among participants not taking antihypertensive medication (127.1[standard deviation 12.8] vs. 124.5[15.7] mm Hg, respectively) and taking antihypertensive medication (131.2[13.6] vs. 130.0[15.6] mm Hg, respectively). Mean daytime diastolic BP was higher than clinic diastolic BP among participants not taking antihypertensive medication (78.2[standard deviation 8.9] vs. 74.6[8.4] mm Hg, respectively) and taking antihypertensive medication (77.6[9.4] vs. 74.3[8.5] mm Hg, respectively). The prevalence of daytime hypertension was higher than clinic hypertension for participants not taking antihypertensive medication (31.8% vs. 14.3%) and taking antihypertensive medication (43.0% vs. 23.1%). A high percentage of participants not taking and taking antihypertensive medication had nocturnal hypertension (49.4% and 61.7%, respectively), white-coat hypertension (30.2% and 29.3%, respectively), masked hypertension (25.4% and 34.6%, respectively), and a nondipping BP pattern (62.4% and 69.6%, respectively). In conclusion, these data suggest hypertension may be misdiagnosed among African Americans without using ABPM.
  • Keywords

  • Ambulatory blood pressure monitoring, masked hypertension, nocturnal hypertension, nondipping, Adult, African Americans, Aged, Antihypertensive Agents, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Circadian Rhythm, Cohort Studies, Diagnostic Errors, Female, Humans, Male, Masked Hypertension, Middle Aged, Prevalence, Risk Assessment, Risk Factors, United States, White Coat Hypertension
  • Digital Object Identifier (doi)

    Author List

  • Thomas SJ; Booth JN; Bromfield SG; Seals SR; Spruill TM; Ogedegbe G; Kidambi S; Shimbo D; Calhoun D; Muntner P
  • Start Page

  • 204
  • End Page

  • 212.e5
  • Volume

  • 11
  • Issue

  • 4