The purpose of this study was to examine ambulatory blood pressure and heart rate patterns in healthy, normotensive adolescents and to determine the influence of race and gender on these patterns. Ambulatory blood pressure recordings were performed on 199 adolescents; 42 were black males, 55 were white males, 65 were black females, and 37 were white females. The mean age (±SD) was 13±2 years. Blood pressure readings were obtained with an automatic, noninvasive recorder. Black adolescents and white adolescents had similar blood pressures while awake (116/69 vs. 116/69 mm Hg), with boys having higher levels of systolic blood pressure (118 vs. 114 mm Hg) and comparable levels of diastolic blood pressure (69 vs. 69 mm Hg) relative to girls. The patterns while the adolescents were asleep, however, were different. White boys (106 mm Hg), white girls (105 mm Hg), and black girls (105 mm Hg) had similar systolic blood pressures during sleep. Black boys (112 mm Hg), however, had significantly higher systolic blood pressures while asleep. Black adolescents, as a group, had significantly higher diastolic blood pressures than white adolescents while asleep (64 vs. 61 mm Hg). Changes in blood pressure from awake to asleep were not related to changes in heart rate. Results of this study indicate that both race and gender are important determinants of the diurnal pattern of blood pressure and heart rate in adolescents. (Hypertension 1989;14:598-603)

We examined the effects of aerobic fitness and race on the diurnal rhythm of blood pressure of 175 healthy adolescents who performed a cycle ergometer maximal exercise test while oxygen consumption was measured. A median split of maximum oxygen consumption for boys and girls separately classified them as either "more-fit" or "less-fit" subjects. Ambulatory blood pressure recordings were also performed, and the data were analyzed for means while subjects were awake and asleep. Less-fit black boys had higher systolic pressures than more-fit black boys while awake (124 vs. 115 mm Hg;/><0.009) and asleep (117 vs. 108;p<0.001). Less-fit black boys also had higher systolic pressures than less-fit white boys while awake (114;/?< 0.002) and asleep (105; /?< 0.001), and they had higher systolic pressures than more-fit white boys while asleep (105;p<0.01). Less-fit black girls had higher systolic pressures than more-fit black girls while awake (116 vs. 109;p<0.004) and asleep (109 vs. 100;p<0.001). Less-fit black girls also had higher diastolic pressures than more-fit black girls while awake (71 vs. 66; p< 0.002) and asleep (66 vs. 61;p<0.001). In addition, less-fit black girls had higher systolic pressures than more-fit white girls while asleep (104; p< 0.05), higher diastolic pressures than more-fit white girls while awake (68;p<0.05) and asleep (60; p< 0.006), and higher diastolic pressures than less-fit white girls while asleep (61;/?< 0.001). These findings indicate that fitness influences ambulatory blood pressure profiles, particularly in black adolescents. {Hypertension 1990;15:810-814) P revious studies using ambulatory blood pressure monitoring have demonstrated racial differences in the diurnal rhythm of blood pressure in adolescents 1 and adults.2 -3 Specifically, black individuals and white individuals have similar levels of blood pressure while awake, but black individuals have higher levels of blood pressure while asleep. Aerobic fitness may be a second factor that influences the diurnal variation of blood pressure. Increased physical activity and aerobic fitness are associated with lower casual blood pressure, 4 -11 as well as a reduced risk for the development of hypertension and coronary heart disease. 12- 15 The purpose of the present study was to examine the effects of aerobic fitness and the interaction between aerobic fitness and race on the diurnal variation of blood pressure in healthy, normotensive adolescents. Methods SubjectsA biracial sample of 226 healthy, normotensive children between the ages of 10 and 18 years was recruited as part of an ongoing study evaluating hypertensive risk factors in children. A total of 175 of the 226 children (77%) completed both the cycle ergometer maximal exercise test and the ambulatory blood pressure recording. Parental consent was obtained before testing.The sample included 80 boys and 95 girls, who were divided into "more-fit" and "less-fit" categories based on a median split of maximum oxygen consumption (Vc^max) performed separately for boys and girls. The...

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