West African Ancestry and Nocturnal Blood Pressure in African Americans: The Jackson Heart Study

Booth, John N.; Li, Man; Shimbo, Daichi; Hess, Rachel; Irvin, Marguerite R.; Kittles, Rick A.; Wilson, James G.; Jorde, Lynn B.; Cheung, Alfred K.; Lange, Leslie A.; Lange, Ethan M.; Yano, Yuichiro; Muntner, Paul; Bress, Adam P.

doi:10.1093/ajh/hpy038

Cited by 6 publications

(6 citation statements)

References 46 publications

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“…Finally, in line with studies in adults, we also identified that Black race was significantly associated with blunted nocturnal dipping in children with glomerular CKD (36,37). Further studies in children are needed to determine whether these racial differences are related to environmental factors, diet, genetic differences, or a combination of these (38).…”

Section: Discussionmentioning

confidence: 99%

Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort

Bakhoum

Katz

Samuels

et al. 2022

CJASN

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Background and objectives: The physiological nocturnal blood pressure decline is often blunted in patients with chronic kidney disease (CKD); however, the consequences of blood pressure non-dipping in children are largely unknown. Our objective was to determine risk factors for non-dipping and to investigate if non-dipping is associated with higher left ventricular mass index (LVMI) in children with CKD. Design, setting, participants, and measurements: We conducted a cross-sectional analysis of ambulatory blood pressure monitoring and echocardiographic data in participants of the Chronic Kidney Disease in Children study. Multivariable linear and spline regression analyses were used to evaluate the relationship of risk factors with dipping, and of dipping with LVMI. Results: Within 552 participants, mean age was 11 (± 4) years, mean eGFR was 53 (± 20) ml/min/1.73m2, and 41% were classified as non-dippers. In subjects with non-glomerular CKD, female sex and higher sodium intake were significantly associated with less systolic and diastolic dipping (p≤ 0.05). In those with glomerular CKD, African American race and greater proteinuria were significantly associated with less systolic and diastolic dipping (p≤ 0.05). Systolic and diastolic dipping were not significantly associated with LVMI; however, in spline regression plots, diastolic dipping appeared to have a non-linear relationship with LVMI. As compared to diastolic dipping of 20-25%, dipping of < 20% was associated with 1.41 g/m2.7 higher LVMI (95% CI -0.47, 3.29), and dipping of > 25% was associated with 1.98 g/m2.7 higher LVMI (95% CI -0.77, 4.73), though these relationships did not achieve statistical significance. Conclusion: African American race, female sex, and greater proteinuria and sodium intake were significantly associated with blunted dipping in children with CKD. We did not find a statistically significant association between dipping and LVMI.

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Section: Discussionmentioning

confidence: 99%

Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort

Bakhoum

Katz

Samuels

et al. 2022

CJASN

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“…When adopting a social sciences theory of health disparities, scientists estimating causal effects of genetic ancestry on health outcomes should control for variables assumed to be consequences of historical systematic racism, discrimination, and segregation to avoid conflating genetic ancestry effects with these other correlates of SIRE. A growing number of multilevel studies have examined African ancestry as a predictor of chronic disease endpoints [20,21,36,46,[63][64][65][66][67]. Geographic analyses of migration patterns in the US have shown that genetic admixture patterns in present-day African Americans are associated with forced movements of people that occurred during the trans-Atlantic slave trade [23,24].…”

Section: Plos Onementioning

confidence: 99%

Relative impact of genetic ancestry and neighborhood socioeconomic status on all-cause mortality in self-identified African Americans

et al. 2022

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Self-identified race/ethnicity is a correlate of both genetic ancestry and socioeconomic factors, both of which may contribute to racial disparities in mortality. Investigators often hold a priori assumptions, rarely made explicit, regarding the relative importance of these factors. We studied 2,239 self-identified African Americans (SIAA) from the Prostate, Lung, Colorectal and Ovarian screening trial enrolled from 1993–1998 and followed prospectively until 2019 or until death, whichever came first. Percent African genetic ancestry was estimated using the GRAF-Pop distance-based method. A neighborhood socioeconomic status (nSES) index was estimated using census tract measures of income, housing, and employment and linked to participant residence in 2012. We used Directed Acyclic Graphs (DAGs) to represent causal models favoring (1) biomedical and (2) social causes of mortality. Hazard ratios were estimated using Cox models adjusted for sociodemographic, behavioral, and neighborhood covariates guided by each DAG. 901 deaths occurred over 40,767 person-years of follow-up. In unadjusted (biomedical) models, a 10% increase in percent African ancestry was associated with a 7% higher rate of all-cause mortality (HR: 1.07, 95% CI: 1.02, 1.12). This effect was attenuated in covariate adjusted (social) models (aHR: 1.01, 95% CI: 0.96, 1.06). Mortality was lower comparing participants in the highest to lowest nSES quintile following adjustment for covariates and ancestry (aHR: 0.74, 95% CI: 0.57, 0.98, Ptrend = 0.017). Higher African ancestry and lower nSES were associated with higher mortality, but African ancestry was not associated with mortality following covariate adjustment. Socioeconomic factors may be more important drivers of mortality in African Americans.

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“…Disentangling the contributions of genetic, societal, and environmental factors toward disparities in hypertension has important clinical and public health implications for improving care and reducing the morbidity and mortality attributed to hypertension among Black individuals . Hypertension affects nearly 1 in 2 Black adults, who additionally experience higher rates of severe, nocturnal, and nondipping phenotypes, as well as reduced responsiveness to standard BP regimens, contributing to notions of an innate biological risk associated with Black race . In SPRINT, prior studies reported racial differences in the risk of adverse outcomes and the number of antihypertensive medications required to reach the intensive SBP goal.…”

Section: Discussionmentioning

confidence: 99%

Association of Genetic West African Ancestry, Blood Pressure Response to Therapy, and Cardiovascular Risk Among Self-reported Black Individuals in the Systolic Blood Pressure Reduction Intervention Trial (SPRINT)

et al. 2021

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IMPORTANCE Self-identified Black race is associated with higher hypertension prevalence and worse blood pressure (BP) control compared with other race/ethnic groups. The contribution of genetic West African ancestry to these racial disparities appears not to have been completely determined.OBJECTIVE To determine the association between the proportion of West African ancestry with the response to antihypertensive medication, BP control, kidney function, and risk of adverse cardiovascular (CV) events among self-identified Black individuals in the Systolic Blood Pressure Intervention Trial (SPRINT). DESIGN, SETTING, AND PARTICIPANTSThis post hoc analysis of the SPRINT trial incorporated data from a multicenter study of self-identified Black participants with available West African ancestry proportion, estimated using 106 biallelic autosomal ancestry informative genetic markers.

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West African Ancestry and Nocturnal Blood Pressure in African Americans: The Jackson Heart Study

Cited by 6 publications

References 46 publications

Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort

Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort

Relative impact of genetic ancestry and neighborhood socioeconomic status on all-cause mortality in self-identified African Americans

Association of Genetic West African Ancestry, Blood Pressure Response to Therapy, and Cardiovascular Risk Among Self-reported Black Individuals in the Systolic Blood Pressure Reduction Intervention Trial (SPRINT)

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