Race and gender influence ambulatory blood pressure patterns of adolescents.

Harshfield, Gregory A.; Alpert, Bruce S.; Willey, Elaine S.; Somes, Grant W.; Murphy, Joseph K.; Dupaul, L. M.

doi:10.1161/01.hyp.14.6.598

Cited by 130 publications

(54 citation statements)

References 12 publications

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“…In a previous study, we demonstrated that the blood pressures of black and white children were similar while the children were awake but that black children had higher blood pressures than white children during sleep. 1 In a second study, Harshfield et al 2 extended these findings to healthy, normotensive black adults without a history of disease. In contrast to previous reports in white adults, 18 they reported that black adults did not show a significant decline in blood pressure during sleep.…”

Section: Girls E Fit Whitementioning

confidence: 94%

“…1 The subject was instructed to relax the arm for a blood pressure determination and to provide diary information for each hour the monitor was worn, including the time of sleep and awakening. The child then resumed normal daily activities and returned the following day for the removal of the recorder.…”

Section: Ambulatory Blood Pressure and Heart Rate Recordingsmentioning

confidence: 99%

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Aerobic fitness and the diurnal rhythm of blood pressure in adolescents.

et al. 1990

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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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Section: Girls E Fit Whitementioning

confidence: 94%

Section: Ambulatory Blood Pressure and Heart Rate Recordingsmentioning

confidence: 99%

Aerobic fitness and the diurnal rhythm of blood pressure in adolescents.

et al. 1990

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“…6 ' 9 In one study of adolescents, blood pressure at night was higher in blacks than in whites. 10 An increased level of arterial pressure in black children compared with white children would suggest that factors involved in the development of hypertension in blacks are functioning early in life. If the pathophysiology of the hypertension is indeed present in childhood, then studies that include young, normotensive individuals might provide useful information to an understanding of the etiology of hypertension.…”

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Longitudinal assessment of blood pressures in black and white children.

1993

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The prevalence of hypertension is greater for blacks than whites. Whether black children have higher blood pressure than white children is less clear. We investigated this issue through a prospective longitudinal assessment of blood pressure in 345 white children and 164 black children. Each child had his or her blood pressure measured every 6 months for 2 to 5.5 years. The means for systolic and diastolic blood pressures for each individual were calculated, and the rate of change in blood pressure over time for each subject was estimated. The mean blood pressure and the mean rate were compared between gender-specific black and white groups. For both boys and girls, the mean systolic blood pressure was 2 mm Hg higher in black children than white children (/*=.0008). Boys had a higher systolic blood pressure than girls (P=.OO48). The mean diastolic blood pressure was 1.5 mm Hg higher in black children than in white children (P=.O27O); no significant gender difference in diastolic blood pressure was observed. Age, weight, height, and body mass index were highly correlated with blood pressure. When accounting for these variables, for girls the racial difference in systolic blood pressure remained significant, whereas the difference in diastolic blood pressure in boys and girls was no longer significant. The rate of increase in blood pressure over time was significantly greater in blacks than whites: for systolic blood pressure, P=.0002, and for diastolic blood pressure, P=.OO9. There was no sex difference in rate of change in systolic blood pressure, whereas girls showed a greater increase in diastolic blood pressure over time than boys (P=.O131). In summary, the average blood pressure for black children was higher than in white children, and the blood pressure increased at a faster rate in blacks compared with whites. The findings suggest that mechanisms that predispose blacks to hypertension may be functioning in childhood. (Hypertension 1993;22:84-89) KEY WORDS • blacks • blood pressure • hypertension, essential • child H ypertension is more common in blacks than in whites. 1 -2 It remains uncertain, however, whether blood pressure is higher in blacks than in whites before hypertension begins. Some crosssectional studies found slightly higher blood pressure in black children, 35 whereas others described inconclusive findings or found blood pressure to be lower in whites than in blacks.6 ' 9 In one study of adolescents, blood pressure at night was higher in blacks than in whites. 10 An increased level of arterial pressure in black children compared with white children would suggest that factors involved in the development of hypertension in blacks are functioning early in life. If the pathophysiology of the hypertension is indeed present in childhood, then studies that include young, normotensive individuals might provide useful information to an understanding of the etiology of hypertension.We describe here a prospective, longitudinal study of blood pressure in black and white children. Blood pressure was me...

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“…Multiple linear regression analysis showed that older age and decreased BMI were independent determinants of the non-dipper pattern. Environmental factors that may influence the circadian rhythm of BP include smoking, alcohol intake, and sodium intake [43,44]. In our study, non-dippers tended to be older.…”

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The effects of nocturnal dipping on cardiovascular outcomes and proteinuria in essential hypertensive patients

Selçoki

Baybek

et al. 2008

Open Medicine

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AbstractIndividuals who do not have a 10% to 20% reduction in blood pressure (BP) during the night are known as ‘nondippers’. Non-dipping patterns in hypertensive patients have been shown to be associated with an excess of target organ damage and other adverse outcomes. The present study was designed to investigate the relationship between nocturnal BP pattern, defined on the basis of the ambulatory blood pressure monitoring (ABPM) recording, and cardiac and renal target organ damage in a population of at least one year treated essential hypertensive subjects. The present analysis involved 123 patients with treated essential hypertension attending the outpatient clinic of our centre. Each patient was subjected to the following procedures: blood sampling for routine blood chemistry, spot urine for proteinuria, 24-hour periods of ABPM, and echocardiography. In the ABPM period, a dipping pattern was observed in 65 of the 123 patients, and a non-dipping pattern in 58 patients. Body mass index was higher in the non-dippers (26 ± 4 versus 28 ± 4, p<0.05). The proteinuria in spot urine was significantly higher in the non-dippers (10 ± 6 versus 24 ± 48, p<0.03). Left ventricular mass, interventricular septum thickness, posterior wall thickness and left ventricular systolic diameter were significantly higher in the non-dippers compared to the dippers. Left ventricular diastolic function was similar in non-dipper cases, except E-wave deceleration time. In treated essential hypertensives the blunted or absent nocturnal fall in blood pressure can be a strong predictor of cardiac and renal events. Hypertensive patients should be evaluated by ambulatory blood pressure monitoring. To prevent patients at risk for morbidity and mortality casualities as a result of hypertension, patients should be evaluated by ambulatory blood pressure monitoring. This method can be utilized for exacting future follow-ups with the patient.

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Race and gender influence ambulatory blood pressure patterns of adolescents.

Cited by 130 publications

References 12 publications

Aerobic fitness and the diurnal rhythm of blood pressure in adolescents.

Aerobic fitness and the diurnal rhythm of blood pressure in adolescents.

Longitudinal assessment of blood pressures in black and white children.

The effects of nocturnal dipping on cardiovascular outcomes and proteinuria in essential hypertensive patients

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