Jeong Soolim, Linder Braxton A, Barnett Alex M, Tharpe McKenna A, Hutchison Zach J, Culver Meral N, Sanchez Sofia O, Nichols Olivia I, Grosicki Gregory J, Bunsawat Kanokwan, Nasci Victoria L, Gohar Eman Y, Fuller-Rowell Thomas E, Robinson Austin T
Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849.
Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA 36849.
medRxiv. 2023 Sep 12:2023.09.11.23295160. doi: 10.1101/2023.09.11.23295160.
Ambulatory blood pressure () monitoring measures nighttime BP and BP dipping, which are superior to in-clinic BP for predicting cardiovascular disease (), the leading cause of death in America. Compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping, including in young adulthood. Social determinants of health contribute to disparities in CVD risk, but the contribution of neighborhood deprivation on nighttime BP is unclear. Therefore, we examined associations between neighborhood deprivation with nighttime BP and BP dipping in young Black and White adults.
We recruited 21 Black and 26 White participants (20 M/27 F, mean age: 21 years, body mass index: 25±4 kg/m) for 24-hour ambulatory BP monitoring. We assessed nighttime BP and BP dipping (nighttime:daytime BP ratio). The area deprivation index () was used to measure neighborhood deprivation. Associations between ADI and ambulatory BP were examined.
Black participants exhibited higher nighttime diastolic BP compared with White participants (63±8 mmHg vs 58±7 mmHg, =0.003), and attenuated BP dipping ratios for both systolic (0.92±0.06 vs 0.86±0.05, =0.001) and diastolic BP (0.86±0.09 vs 0.78±0.08, =0.007). Black participants experienced greater neighborhood deprivation compared with White participants (ADI scores: 110±8 vs 97±21, <0.001), and ADI was associated with attenuated systolic BP dipping (ρ=0.342, =0.019).
Our findings suggest neighborhood deprivation may contribute to higher nighttime BP and attenuated BP dipping, which are prognostic of CVD, and more prevalent in Black adults. Targeted interventions to mitigate the effects of neighborhood deprivation may help to improve nighttime BP.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT04576338.
动态血压监测可测量夜间血压及血压波动，在预测美国主要死因心血管疾病方面优于诊室血压。与其他种族/族裔群体相比，美国黑人在包括青年期在内的各年龄段均表现出夜间血压升高及血压波动减弱。健康的社会决定因素导致心血管疾病风险存在差异，但邻里贫困对夜间血压的影响尚不清楚。因此，我们研究了邻里贫困与年轻黑人和白人成年人夜间血压及血压波动之间的关联。
我们招募了21名黑人参与者和26名白人参与者（20名男性/27名女性，平均年龄：21岁，体重指数：25±4kg/m²）进行24小时动态血压监测。我们评估了夜间血压及血压波动（夜间：白天血压比值）。采用地区贫困指数（ADI）来衡量邻里贫困程度。研究了ADI与动态血压之间的关联。
与白人参与者相比，黑人参与者夜间舒张压更高（63±8mmHg对58±7mmHg，P = 0.003），收缩压（0.92±0.06对0.86±0.05，P = 0.001）和舒张压（0.86±0.09对0.78±0.08，P = 0.007）的血压波动比值均减弱。与白人参与者相比，黑人参与者经历的邻里贫困程度更高（ADI得分：110±8对97±21，P<0.001），且ADI与收缩压波动减弱相关（ρ = 0.342，P = 0.019）。
我们的研究结果表明，邻里贫困可能导致夜间血压升高及血压波动减弱，这是心血管疾病的预后指标，且在黑人成年人中更为普遍。采取针对性干预措施减轻邻里贫困的影响可能有助于改善夜间血压。
