Napan Sirikarn, Kwagyan John, Randall Otelio S, Xu Shichen, Ketete Muluemebet, Maqbool Abid R
Division of Cardiology, Department of Internal Medicine, Howard University Hospital, Washington, District of Columbia 20060, USA.
Blood Press Monit. 2011 Jun;16(3):111-6. doi: 10.1097/MBP.0b013e328346a871.
Nondipping pattern of circadian blood pressure (BP) is associated with increased cardiovascular morbidity and mortality; however, limited data are available among obese African-Americans. We, therefore, aimed to evaluate the pattern of circadian BP variation and to identify clinical conditions associated with nondipping in this population.
A total of 211 obese African-Americans enrolled in a weight-reduction program underwent 24-h ambulatory BP monitoring. Nondipping was defined as a nocturnal BP reduction of less than 10%.
Systolic BP (SBP) nondipping was present in 158 participants (74.9%) and diastolic BP (DBP) nondipping was present in 93 participants (44.1%). In multivariate logistic regression analyses, diabetes was associated with SBP nondipping (adjusted OR, 2.53; CI: 1.16-5.76; P=0.02), and increasing BMI (5 kg/m) was associated with DBP nondipping (adjusted OR, 1.46; CI: 1.17-1.83; P=0.001). In linear regression analyses, BMI was positively correlated to office, 24-h, daytime, and night-time SBP (P=0.03, 0.01, 0.03, and 0.005, respectively) and office, 24-h, daytime, and night-time PP (P=0.01, P<0.001, 0.001, and P=0.003, respectively).
This study demonstrated an excessively high prevalence of nondippers and independent associations between diabetes and SBP nondipping and between BMI and DBP nondipping in an obese African-American population.
昼夜血压（BP）非勺型模式与心血管疾病发病率和死亡率增加相关；然而，肥胖非裔美国人中的相关数据有限。因此，我们旨在评估昼夜血压变化模式，并确定该人群中与非勺型模式相关的临床情况。
共有211名参加减肥计划的肥胖非裔美国人接受了24小时动态血压监测。非勺型定义为夜间血压降低小于10%。
158名参与者（74.9%）存在收缩压（SBP）非勺型模式，93名参与者（44.1%）存在舒张压（DBP）非勺型模式。在多因素逻辑回归分析中，糖尿病与SBP非勺型模式相关（调整后的OR为2.53；CI：1.16 - 5.76；P = 0.02），体重指数（BMI）每增加5 kg/m²与DBP非勺型模式相关（调整后的OR为1.46；CI：1.17 - 1.83；P = 0.001）。在线性回归分析中，BMI与诊室、24小时、日间和夜间SBP呈正相关（P分别为0.03、0.01、0.03和0.005），与诊室、24小时、日间和夜间脉压（PP）也呈正相关（P分别为0.01、P < 0.001、0.001和P = 0.003）。
本研究表明，在肥胖非裔美国人中，非勺型模式的患病率过高，且糖尿病与SBP非勺型模式以及BMI与DBP非勺型模式之间存在独立关联。
