Stepnowsky Carl J, Nelesen Richard A, DeJardin Doug, Dimsdale Joel E
Department of Psychiatry, University of California, San Diego, San Diego, California, USA.
Psychosom Med. 2004 Sep-Oct;66(5):651-5. doi: 10.1097/01.psy.0000138124.58216.6c.
With the advent of ambulatory blood pressure monitoring has come the awareness that blood pressure (BP) normally drops, or "dips," at night by roughly 10%. A number of pathological conditions have been associated with the nondipping of nocturnal BP. In general, researchers have looked at dipping in neurological and cardiovascular disorders. We examined the extent to which nocturnal nondipping might be influenced by relatively gross measures of social environment.
This study examined 78 healthy adults and adults with mild hypertension who were not currently receiving medication, aged 25 to 52 years (mean age = 38.2). Forty-two participants self-identified as black and 36 identified as white.
Age, body mass index, apnea-hypopnea index, screening BP, ethnicity, and socioeconomic status (SES) were significantly associated with nocturnal BP dipping, accounting for 41% of the variance in dipping (F[6,51] = 5.473, p <.001). When SES was entered on the last step of a hierarchical regression analysis, it independently accounted for 8% of the variance in dipping, even after accounting for ethnicity, such that the lower the SES, the more the nondipping.
It remains to be seen what aspect of the social environment may be driving this association between nondipping and lower social class. However, investigators might consider including social class in their models in future studies.
随着动态血压监测的出现,人们开始意识到血压(BP)通常在夜间会下降,即“血压谷值”,降幅约为10%。许多病理状况都与夜间血压不降有关。一般来说,研究人员关注的是神经和心血管疾病中的血压谷值情况。我们研究了相对粗略的社会环境指标可能在多大程度上影响夜间血压不降。
本研究对78名健康成年人以及未接受药物治疗的轻度高血压成年人进行了检查,他们的年龄在25至52岁之间(平均年龄 = 38.2岁)。42名参与者自我认定为黑人,36名认定为白人。
年龄、体重指数、呼吸暂停低通气指数、筛查血压、种族以及社会经济地位(SES)与夜间血压谷值显著相关,解释了血压谷值变化的41%(F[6,51] = 5.473,p <.001)。在分层回归分析的最后一步纳入SES时,即使在考虑了种族因素之后,它仍独立解释了血压谷值变化的8%,即SES越低,血压不降越明显。
社会环境的哪个方面可能导致血压不降与较低社会阶层之间的这种关联,仍有待观察。然而,研究人员在未来的研究中可能会考虑将社会阶层纳入他们的模型。