Masked Hypertension and Incident Clinic Hypertension Among Blacks in the Jackson Heart Study

Abdalla, Marwah; Booth, John N.; Seals, Samantha R.; Spruill, Tanya M.; Viera, Anthony J.; Diaz, Keith M.; Sims, Mario; Muntner, Paul; Shimbo, Daichi

doi:10.1161/hypertensionaha.115.06904

Cited by 36 publications

(33 citation statements)

References 48 publications

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“…This substudy included 2115 participants for which BP was assessed simultaneously by random-zero sphygmomanometer and the Omron HEM-907XL device using a Y-connector. As described elsewhere [25], the random-zero BP measurements were calibrated to the semiautomatic oscillometric device using robust regression. The calibrated clinic BP values were used for the primary analyses with non-calibrated BP used in sensitivity analysis.…”

Section: Methodsmentioning

confidence: 99%

Masked hypertension and kidney function decline

Mwasongwe

Min

Booth

et al. 2018

Journal of Hypertension

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Background Hypertension diagnosed by blood pressure (BP) measured in the clinic is associated with rapid kidney function decline (RKFD) and incident chronic kidney disease (CKD). The extent to which hypertension defined using out-of-clinic BP measurements is associated with these outcomes is unclear. Methods We evaluated the association of any masked hypertension (daytime SBP/DBP ≥ 135/85 mmHg, night-time SBP/DBP ≥ 120/70 mmHg or 24-h SBP/DBP ≥ 130/80 mmHg) with RKFD and incident CKD among 676 African-Americans in the Jackson Heart Study with clinic-measured SBP/DBP less than 140/90 mmHg who completed ambulatory BP monitoring in 2000–2004. RKFD was defined as a decline in estimated glomerular filtration rate (eGFR) at least 30% and incident CKD was defined as development of eGFR less than 60 ml/min per 1.73 m2 with an at least 25% decline in eGFR between 2000–2004 and 2009–2013. Results The mean age of participants was 57.6 years, 28.8% were men and 52.7% had any masked hypertension. After a median follow-up of 8 years, 13.8 and 8.6% of participants had RKFD and incident CKD, respectively. In unadjusted analyses, masked hypertension was associated with an increased odds for incident CKD [odds ratio (OR) 2.20, 95% confidence interval (CI) 1.22, 3.97]. This association remained statistically significant after adjustment for demographic characteristics, baseline eGFR and albumin-to-creatinine ratio (OR 1.95, 95% CI 1.04, 3.67) but was eliminated after propensity score adjustment (OR 1.62, 95% CI 0.87, 3.00). There was no association between masked hypertension and RKFD. Conclusion Masked hypertension may be associated with the development of CKD in African-Americans.

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Section: Methodsmentioning

confidence: 99%

Masked hypertension and kidney function decline

Mwasongwe

Min

Booth

et al. 2018

Journal of Hypertension

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“…A BP comparability sub-study was performed in 2,115 participants who had their BP measured simultaneously with a random-zero sphygmomanometer and the oscillometric device using a Y-connector at Exam 2. 25 Since semi-automated devices are commonly used in clinical practice, the random-zero BP measurements were calibrated to the semi-automated device by modeling the differences in BP measurements between devices as a function of the random-zero sphygmomanometer. Detailed information related to the calibration is provided in the Supplemental Materials.…”

Section: Methodsmentioning

confidence: 99%

Cardiovascular Health and Incident Hypertension in Blacks

et al. 2017

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Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trend<0.001). This association was present among participants with baseline systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg and, separately systolic blood pressure 120–139 or diastolic blood pressure 80–89 mmHg. African-Americans with better cardiovascular health have lower hypertension risk.

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“…Since semi-automated devices are commonly used in the clinic setting, the random-zero BP measurements were calibrated to a semi-automated device using robust regression as described previously. 13 …”

Section: Methodsmentioning

confidence: 99%

Cardiovascular Risk Factors and Masked Hypertension

et al. 2016

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Masked hypertension is associated with increased risk for cardiovascular disease. Identifying modifiable risk factors for masked hypertension could provide approaches to reduce its prevalence. Life’s Simple 7 is a measure of cardiovascular health developed by the American Heart Association that includes body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), cholesterol, and glucose. We examined the association between cardiovascular health and masked daytime hypertension in the Jackson Heart Study, an exclusively African-American cohort. Life’s Simple 7 factors were assessed during a study visit and categorized as poor, intermediate, or ideal. Ambulatory BP monitoring was performed following the study visit. Using BP measured between 10am and 8pm on ABPM, masked daytime hypertension was defined as mean clinic systolic/diastolic BP (SBP/DBP) <140/90 mmHg and mean daytime SBP/DBP ≥135/85 mmHg. Among the 758 participants with SBP/DBP<140/90 mmHg, 30.5% had masked daytime hypertension. The multivariable-adjusted prevalence ratios for masked daytime hypertension comparing participants with 2, 3 and ≥4 versus ≤1 ideal Life’s Simple 7 factors were 0.99 (95%CI: 0.74–1.33), 0.77 (95%CI: 0.57–1.03) and 0.51 (95%CI: 0.33–0.79), respectively. Masked daytime hypertension was less common among participants with ideal versus poor levels of physical activity (ratio: 0.74, 95% CI: 0.56–1.00), ideal or intermediate levels pooled together versus poor diet (prevalence ratio: 0.73, 95% CI: 0.58–0.91), ideal versus poor levels of cigarette smoking (prevalence ratio: 0.61, 95% CI: 0.46–0.82), and ideal versus intermediate levels of clinic BP (prevalence ratio: 0.28, 95% CI: 0.16–0.48). Better cardiovascular health is associated with a lower prevalence of masked hypertension.

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Masked Hypertension and Incident Clinic Hypertension Among Blacks in the Jackson Heart Study

Cited by 36 publications

References 48 publications

Masked hypertension and kidney function decline

Masked hypertension and kidney function decline

Cardiovascular Health and Incident Hypertension in Blacks

Cardiovascular Risk Factors and Masked Hypertension

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