Harshfield Gregory A, Treiber Frank A, Wilson Martha E, Kapuku Gaston K, Davis Harry C
Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta 30912-4534, USA.
Am J Hypertens. 2002 Jun;15(6):525-30. doi: 10.1016/s0895-7061(02)02267-7.
Many studies demonstrated an ethnic difference in ambulatory blood pressure (BP) patterns. We examined: 1) the stability of this difference; 2) demographic and anthropometric characteristics that predict the difference over 2 years; and 3) the clinical significance of the difference.
Recordings were performed 2 years apart on 94 African American and 92 European American youths with a positive family history of hypertension, aged 14 +/- 2 years at initial testing.
African Americans had higher nighttime systolic BP (SBP) on the initial (109 +/- 9 v 105 +/- 8 mm Hg; P < .001) and follow-up (110 +/- 10 v 105 +/- 8 mm Hg; P < .0001) visits despite similar daytime SBP. This was associated with greater left ventricular mass/height2.7 (LVM/height2.7) during the initial (31 +/- 8 v 28 +/- 6 g/height2.7; P < .01) and follow-up (32 +/- 8 v 28 +/- 8 g/height2.7; P < .02) visits. Sex accounted for 17% (P < .0001) of the variance of follow-up daytime SBP in African Americans, and age for an additional 10% (P < .001). In comparison, initial height accounted for 11% (P < .001) of the variance in European Americans. Sex accounted for 18% (P < .0001) of the variance of follow-up nighttime SBP in African Americans, age for an additional 12% (P < .0001), and initial LVM/height2.7 an additional 6% (P < .02). In contrast, sex accounted for 13% of the variance of follow-up nighttime SBP in European Americans, and initial height accounted for an additional 8% (P < .004).
The pattern of higher nighttime BP despite similar daytime BP in African Americans is stable over time, with sex as the most important predictor of nighttime BP in both groups. This study provides confirmatory data on the clinical significance of the differences.
许多研究表明动态血压模式存在种族差异。我们研究了：1）这种差异的稳定性；2）2年内预测该差异的人口统计学和人体测量学特征；3）该差异的临床意义。
对94名非裔美国青年和92名有高血压家族史的欧美青年进行了两次相隔2年的记录，初次检测时年龄为14±2岁。
尽管日间收缩压相似，但非裔美国人在初次就诊（109±9 vs 105±8 mmHg；P<.001）和随访就诊（110±10 vs 105±8 mmHg；P<.0001）时夜间收缩压更高。这与初次就诊（31±8 vs 28±6 g/height2.7；P<.01）和随访就诊（32±8 vs 28±8 g/height2.7；P<.02）时更大的左心室质量/身高2.7（LVM/height2.7）相关。性别占非裔美国人随访日间收缩压方差的17%（P<.0001），年龄额外占10%（P<.001）。相比之下，初次身高占欧美裔美国人方差的11%（P<.001）。性别占非裔美国人随访夜间收缩压方差的18%（P<.0001），年龄额外占12%（P<.0001），初次LVM/height2.7额外占6%（P<.02）。相比之下，性别占欧美裔美国人随访夜间收缩压方差的13%，初次身高额外占8%（P<.004）。
非裔美国人尽管日间血压相似但夜间血压较高的模式随时间稳定，性别是两组夜间血压的最重要预测因素。本研究提供了关于这些差异临床意义的确证数据。
