TY - JOUR
T1 - Socioeconomic status, psychosocial factors, race and nocturnal blood pressure dipping in a hispanic cohort
AU - Rodriguez, Carlos J.
AU - Jin, Zhezhen
AU - Schwartz, Joseph E.
AU - Turner-Lloveras, Daniel
AU - Sacco, Ralph L.
AU - Di Tullio, Marco R.
AU - Homma, Shunichi
N1 - Funding Information:
The authors thank the staff and the participants of the NOMAS for their valuable contributions. In particular, the authors acknowledge Janet T. De Rosa, Research Manager for the NOMAS, whose insight and support was invaluable in the execution of this ancillary study. This research was supported in part by an NIH/NINDS R01 NS 29993 (to Dr Sacco), an NHLBI P01 HL047540 (to Dr Schwartz), the Robert Wood Johnson Harold Amos Medical Faculty Development Program (to Dr Rodriguez), and an NHLBI K23 HL079343 (to Dr Rodriguez).
PY - 2013/5
Y1 - 2013/5
N2 - Background Little information is available about the relationship of socioeconomic status (SES) to blunted nocturnal ambulatory blood pressure (ABP) dipping among Hispanics and whether this relationship differs by race. We sought to characterize ABP nondipping and its determinants in a sample of Hispanics. Methods We enrolled 180 Hispanic participants not on antihypertensive medications. SES was defined by years of educational attainment. All participants underwent 24-hour ABP monitoring. A decrease of <10% in the ratio between average awake and average asleep systolic BP was considered nondipping. Results The mean age of the cohort was 67.1 ± 8.7, mean educational level was 9.4 ± 4.4 years, and 58.9% of the cohort was female. The cohort was comprised of 78.3% Caribbean Hispanics with the rest from Mexico and Central/South America; 41.4% self-identified as white Hispanic, 34.4% self-identified as black Hispanic, and 24.4% did not racially self-identify. The percentage of nondippers was 57.8%. Educational attainment (10.5 years vs. 8.6 years; P <0.01) was significantly higher among dippers than nondippers. In multivariable analyses, each 1-year increase in education was associated with a 9% reduction in the likelihood of being a nondipper (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84-0.98; P = 0.01). There were significantly greater odds of being a nondipper for black Hispanics than for white Hispanics (OR, 2.83, 95% CI, 1.29-6.23; P = 0.005). Higher SES was significantly protective of nondipping in white Hispanics but not black Hispanics. Conclusions These Results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation.
AB - Background Little information is available about the relationship of socioeconomic status (SES) to blunted nocturnal ambulatory blood pressure (ABP) dipping among Hispanics and whether this relationship differs by race. We sought to characterize ABP nondipping and its determinants in a sample of Hispanics. Methods We enrolled 180 Hispanic participants not on antihypertensive medications. SES was defined by years of educational attainment. All participants underwent 24-hour ABP monitoring. A decrease of <10% in the ratio between average awake and average asleep systolic BP was considered nondipping. Results The mean age of the cohort was 67.1 ± 8.7, mean educational level was 9.4 ± 4.4 years, and 58.9% of the cohort was female. The cohort was comprised of 78.3% Caribbean Hispanics with the rest from Mexico and Central/South America; 41.4% self-identified as white Hispanic, 34.4% self-identified as black Hispanic, and 24.4% did not racially self-identify. The percentage of nondippers was 57.8%. Educational attainment (10.5 years vs. 8.6 years; P <0.01) was significantly higher among dippers than nondippers. In multivariable analyses, each 1-year increase in education was associated with a 9% reduction in the likelihood of being a nondipper (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84-0.98; P = 0.01). There were significantly greater odds of being a nondipper for black Hispanics than for white Hispanics (OR, 2.83, 95% CI, 1.29-6.23; P = 0.005). Higher SES was significantly protective of nondipping in white Hispanics but not black Hispanics. Conclusions These Results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation.
KW - Hispanics
KW - ambulatory blood pressure monitoring
KW - blood pressure
KW - hypertension
KW - psychosocial
KW - race
KW - socioeconomic status
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U2 - 10.1093/ajh/hpt009
DO - 10.1093/ajh/hpt009
M3 - Article
C2 - 23547037
AN - SCOPUS:84876563458
SN - 0895-7061
VL - 26
SP - 673
EP - 682
JO - American journal of hypertension
JF - American journal of hypertension
IS - 5
ER -