Jackson State University, Jackson Heart Study, Jackson, Mississippi, USA.
Am J Hypertens. 2011 Sep;24(9):1015-21. doi: 10.1038/ajh.2011.98. Epub 2011 Jun 9.
Blunted nocturnal blood pressure (NBP) dipping is a significant predictor of cardiovascular events. Lower socioeconomic position (SEP) may be an important predictor of NBP dipping, especially in African Americans (AA). However, the determinants of NBP dipping are not fully understood.
The cross-sectional associations of individual and neighborhood SEP with NBP dipping, assessed by 24-h ambulatory BP monitoring, were examined among 837 AA adults (Mean age: 59.2 ± 10.7 years; 69.2% women), after adjustment for age, sex, hypertension status, body mass index (BMI), health behaviors, office, and 24-h systolic BP (SBP).
The mean hourly SBP was consistently lower among participants in the highest category of individual income compared to those in the lowest category, and these differences were most pronounced during sleeping hours. The odds of NBP dipping (defined as >10% decline in the mean asleep SBP compared to the mean awake SBP) increased by 31% (95% confidence interval: 13-53%) and 18% (95% confidence interval: 0-39%) for each s.d. increase in income and years of education, respectively, after multivariable adjustment.
NBP dipping is patterned by income and education in AA adults even after accounting for known risk factors. These results suggest that low SEP is a risk factor for insufficient NBP dipping in AA.
夜间血压（NBP）下降幅度变平是心血管事件的一个重要预测指标。较低的社会经济地位（SEP）可能是 NBP 下降的一个重要预测因素，尤其是在非裔美国人（AA）中。然而，NBP 下降的决定因素尚未完全阐明。
本横断面研究在调整了年龄、性别、高血压状况、体重指数（BMI）、健康行为、诊室和 24 小时收缩压（SBP）后，检查了个体和社区 SEP 与通过 24 小时动态血压监测评估的 NBP 下降幅度之间的关联，研究对象为 837 名 AA 成年人（平均年龄：59.2 ± 10.7 岁；69.2%为女性）。
与最低收入组相比，个人收入最高组的参与者平均每小时 SBP 始终较低，且这些差异在睡眠期间最为明显。与平均清醒 SBP 相比，NBP 下降（定义为平均睡着 SBP 下降超过 10%）的几率分别增加了 31%（95%置信区间：13-53%）和 18%（95%置信区间：0-39%），这与收入和受教育年限每增加一个标准差相关，调整了多个变量后依然如此。
即使考虑了已知的危险因素，AA 成年人的 NBP 下降幅度仍与收入和教育程度有关。这些结果表明，低 SEP 是非裔美国人 NBP 下降幅度不足的一个风险因素。
