Prevalence of Masked Hypertension and Its Association With Subclinical Cardiovascular Disease in African Americans: Results From the Jackson Heart Study.

Academic Article

Abstract

  • BACKGROUND: Studies consisting mostly of whites have shown that the prevalence of masked hypertension differs by prehypertension status. Using data from the Jackson Heart Study, an exclusively African American population-based cohort, we evaluated the association of masked hypertension and prehypertension with left ventricular mass index and common carotid intima media thickness. METHODS AND RESULTS: At the baseline visit, clinic blood pressure (CBP) measurement and 24-hour ambulatory blood pressure monitoring were performed. Masked hypertension was defined as mean systolic/diastolic CBP <140/90 mm Hg and mean daytime systolic/diastolic ambulatory blood pressure ≥135/85 mm Hg. Clinic hypertension was defined as mean systolic/diastolic CBP ≥140/90 mm Hg. Normal CBP was defined as mean systolic/diastolic CBP <120/80 mm Hg and prehypertension as mean systolic/diastolic CBP 120 to 139/80 to 89 mm Hg. The analytic sample included 909 participants. Among participants with systolic/diastolic CBP <140/90 mm Hg, the prevalence of masked hypertension and prehypertension was 27.5% and 62.4%, respectively. The prevalence of masked hypertension among those with normal CBP and prehypertension was 12.9% and 36.3%, respectively. In a fully adjusted model, which included prehypertension status and antihypertensive medication use as covariates, left ventricular mass index was 7.94 g/m(2) lower among those without masked hypertension compared to participants with masked hypertension (P<0.001). Left ventricular mass index was also 4.77 g/m(2) lower among those with clinic hypertension, but this difference was not statistically significant (P=0.068). There were no significant differences in left ventricular mass index between participants with and without masked hypertension, or clinic hypertension. CONCLUSIONS: Masked hypertension was common among African Americans with prehypertension and also normal CBP, and was associated with subclinical cardiovascular disease.
  • Authors

    Keywords

  • blood pressure, cardiovascular diseases, epidemiology, hypertension, African Americans, Aged, Antihypertensive Agents, Asymptomatic Diseases, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Carotid Artery Diseases, Carotid Intima-Media Thickness, Cross-Sectional Studies, Female, Humans, Hypertrophy, Left Ventricular, Male, Masked Hypertension, Middle Aged, Mississippi, Multivariate Analysis, Prehypertension, Prevalence, Risk Assessment, Risk Factors
  • Digital Object Identifier (doi)

    Author List

  • Redmond N; Booth JN; Tanner RM; Diaz KM; Abdalla M; Sims M; Muntner P; Shimbo D
  • Start Page

  • e002284
  • Volume

  • 5
  • Issue

  • 3