Harshfield Gregory A, Wilson Martha E, Treiber Frank A, Alpert Bruce S
Department of Pediatrics and Georgia Prevention Institute, Medical College of Georgia, Augusta, 30912-4534, USA.
Blood Press Monit. 2002 Oct;7(5):265-9. doi: 10.1097/00126097-200210000-00003.
Black individuals are characterized by a blunted nocturnal decline (i.e. dipping) in blood pressure compared with whites. The resulting increase in cardiovascular load has been hypothesized to contribute to ethnic differences in hypertension and its sequelae.
To examine data from two different locations and determine factors related to ethnic differences in ambulatory blood pressure pattern.
Ambulatory blood pressure recordings were performed on 300 youths from Memphis, Tennessee and 195 youths from Augusta, Georgia, USA. Stepwise regressions were performed to determine the factors associated with daytime and night-time blood pressure and the nocturnal decline in blood pressure. The factors examined were recording location, ethnicity, gender, age, height, weight and genetic predisposition.
Significant factors in the model for the nocturnal decline in systolic blood pressure included location (R(2) = 0.031, P < 0.001), followed by ethnicity (R(2) change = 0.015, P < 0.006) and height (R(2) change = 0.009,P < 0.03). Significant factors in the model for the nocturnal decline in diastolic blood pressure included location ( R(2) = 0.176, P < 0.001), followed by ethnicity ( R(2) change = 0.016, P < 0.002) and height (R(2) change = 0.02, P < 0.001). The nocturnal decline was greater in the Augusta subjects because of higher daytime systolic (P < 0.002) and diastolic (P < 0.001) blood pressure. Weight contributed significantly to the models for resting blood pressure and daytime blood pressure. Gender was the only variable that contributed to the model for resting systolic blood pressure.
Both genetic and environmental factors contribute to individual differences in ambulatory blood pressure patterns. Much of the variance of ambulatory blood pressure levels and patterns remains, however, unexplained.
与白人相比，黑人的夜间血压下降（即血压勺型变化）较为平缓。据推测，由此导致的心血管负荷增加是造成高血压及其后遗症种族差异的原因之一。
研究来自两个不同地点的数据，并确定与动态血压模式种族差异相关的因素。
对来自美国田纳西州孟菲斯市的300名青少年和佐治亚州奥古斯塔市的195名青少年进行动态血压记录。进行逐步回归分析以确定与日间和夜间血压以及夜间血压下降相关的因素。所研究的因素包括记录地点、种族、性别、年龄、身高、体重和遗传易感性。
收缩压夜间下降模型中的显著因素包括地点（R² = 0.031，P < 0.001），其次是种族（R²变化 = 0.015，P < 0.006）和身高（R²变化 = 0.009，P < 0.03）。舒张压夜间下降模型中的显著因素包括地点（R² = 0.176，P < 0.001），其次是种族（R²变化 = 0.016，P < 0.002）和身高（R²变化 = 0.02，P < 0.001）。由于奥古斯塔市受试者的日间收缩压（P < 0.002）和舒张压（P < 0.001）较高，其夜间血压下降幅度更大。体重对静息血压和日间血压模型有显著影响。性别是静息收缩压模型中唯一有影响的变量。
遗传和环境因素均导致动态血压模式的个体差异。然而，动态血压水平和模式的许多差异仍无法解释。
