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Thresholds for Ambulatory Blood Pressure Among African Americans in the Jackson Heart Study

Ravenell, Joseph ; Shimbo, Daichi ; Booth, John N ; Sarpong, Daniel F ; Agyemang, Charles ; Beatty Moody, Danielle L ; Abdalla, Marwah ; Spruill, Tanya M ; Shallcross, Amanda J ; Bress, Adam P ; Muntner, Paul ; Ogedegbe, Gbenga

Circulation (New York, N.Y.), 2017-06, Vol.135 (25), p.2470-2480 [Periódico revisado por pares]

United States: by the American College of Cardiology Foundation and the American Heart Association, Inc

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  • Título:
    Thresholds for Ambulatory Blood Pressure Among African Americans in the Jackson Heart Study
  • Autor: Ravenell, Joseph ; Shimbo, Daichi ; Booth, John N ; Sarpong, Daniel F ; Agyemang, Charles ; Beatty Moody, Danielle L ; Abdalla, Marwah ; Spruill, Tanya M ; Shallcross, Amanda J ; Bress, Adam P ; Muntner, Paul ; Ogedegbe, Gbenga
  • Assuntos: Adult ; African Americans ; Aged ; Blood Pressure - physiology ; Blood Pressure Monitoring, Ambulatory - methods ; Blood Pressure Monitoring, Ambulatory - standards ; Cohort Studies ; Female ; Humans ; Hypertension - diagnosis ; Hypertension - epidemiology ; Hypertension - physiopathology ; Male ; Middle Aged ; Mississippi - epidemiology ; Prospective Studies
  • É parte de: Circulation (New York, N.Y.), 2017-06, Vol.135 (25), p.2470-2480
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: BACKGROUND:Ambulatory blood pressure (BP) monitoring is the reference standard for out-of-clinic BP measurement. Thresholds for identifying ambulatory hypertension (daytime systolic BP [SBP]/diastolic BP [DBP] ≥135/85 mm Hg, 24-hour SBP/DBP ≥130/80 mm Hg, and nighttime SBP/DBP ≥120/70 mm Hg) have been derived from European, Asian, and South American populations. We determined BP thresholds for ambulatory hypertension in a US population-based sample of African American adults. METHODS:We analyzed data from the Jackson Heart Study, a population-based cohort study comprised exclusively of African American adults (n=5306). Analyses were restricted to 1016 participants who completed ambulatory BP monitoring at baseline in 2000 to 2004. Mean SBP and DBP levels were calculated for daytime (10:00 am–8:00 pm), 24-hour (all available readings), and nighttime (midnight–6:00 am) periods, separately. Daytime, 24-hour, and nighttime BP thresholds for ambulatory hypertension were identified using regression- and outcome-derived approaches. The composite of a cardiovascular disease or an all-cause mortality event was used in the outcome-derived approach. For this latter approach, BP thresholds were identified only for SBP because clinic DBP was not associated with the outcome. Analyses were stratified by antihypertensive medication use. RESULTS:Among participants not taking antihypertensive medication, the regression-derived thresholds for daytime, 24-hour, and nighttime SBP/DBP corresponding to clinic SBP/DBP of 140/90 mm Hg were 134/85 mm Hg, 130/81 mm Hg, and 123/73 mm Hg, respectively. The outcome-derived thresholds for daytime, 24-hour, and nighttime SBP corresponding to a clinic SBP ≥140 mm Hg were 138 mm Hg, 134 mm Hg, and 129 mm Hg, respectively. Among participants taking antihypertensive medication, the regression-derived thresholds for daytime, 24-hour, and nighttime SBP/DBP corresponding to clinic SBP/DBP of 140/90 mm Hg were 135/85 mm Hg, 133/82 mm Hg, and 128/76 mm Hg, respectively. The corresponding outcome-derived thresholds for daytime, 24-hour, and nighttime SBP were 140 mm Hg, 137 mm Hg, and 133 mm Hg, respectively, among those taking antihypertensive medication. CONCLUSIONS:On the basis of the outcome-derived approach for SBP and regression-derived approach for DBP, the following definitions for daytime, 24-hour, and nighttime hypertension corresponding to clinic SBP/DBP ≥140/90 mm Hg are proposed for African American adultsdaytime SBP/DBP ≥140/85 mm Hg, 24-hour SBP/DBP ≥135/80 mm Hg, and nighttime SBP/DBP ≥130/75 mm Hg, respectively.
  • Editor: United States: by the American College of Cardiology Foundation and the American Heart Association, Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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