University of Alabama at Birmingham, Birmingham, Alabama.
Wake Forest University School of Medicine, Winston-Salem.
Blood Press Monit. 2024 Feb 1;29(1):23-30. doi: 10.1097/MBP.0000000000000680. Epub 2023 Sep 21.
Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other than mean BP that are associated with increased risk for cardiovascular events. There are few data on race differences in ABPM parameters other than mean BP.
To estimate differences between White and Black participants in ABPM parameters, we used pooled data from five US-based studies in which participants completed ABPM (n = 2580). We calculated measures of SBP and DBP level, including mean, load, peak, and measures of SBP and DBP variability, including average real variability (ARV) and peak increase.
There were 1513 (58.6%) Black and 1067 (41.4%) White participants with mean ages of 56.1 and 49.0 years, respectively. After multivariable adjustment, asleep SBP and DBP load were 5.7% (95% CI: 3.5-7.9%) and 2.7% (95% CI: 1.1-4.3%) higher, respectively, among Black compared with White participants. Black compared with White participants also had higher awake DBP ARV (0.3 [95%CI: 0.0-0.6] mmHg) and peak increase in DBP (0.4 [95% CI: 0.0-0.8] mmHg). There was no evidence of Black:White differences in awake measures of SBP level, asleep peak SBP or DBP, awake and asleep measures of SBP variability or asleep measures of DBP variability after multivariable adjustment.
Asleep SBP load, awake DBP ARV and peak increase in awake DBP were higher in Black compared to White participants, independent of mean BP on ABPM.
动态血压监测（ABPM）显示，黑人成年人的平均收缩压和舒张压（SBP 和 DBP）高于白人成年人。ABPM 可在 24 小时内获得 48 至 72 次血压测量值，除平均血压外，还可生成与心血管事件风险增加相关的其他参数。关于 ABPM 参数与平均 BP 以外的种族差异的数据很少。
为了估计白人和黑人参与者在 ABPM 参数方面的差异，我们使用了来自五个美国研究的汇总数据，其中参与者完成了 ABPM（n=2580）。我们计算了 SBP 和 DBP 水平的指标，包括平均、负荷、峰值，以及 SBP 和 DBP 变异性的指标，包括平均真实变异性（ARV）和峰值增加。
共有 1513 名（58.6%）黑人参与者和 1067 名（41.4%）白人参与者，平均年龄分别为 56.1 岁和 49.0 岁。经过多变量调整后，黑人参与者的睡眠 SBP 和 DBP 负荷分别高出 5.7%（95%CI：3.5-7.9%）和 2.7%（95%CI：1.1-4.3%）。与白人参与者相比，黑人参与者的清醒 DBP ARV 也更高（0.3[95%CI：0.0-0.6]mmHg）和 DBP 峰值增加（0.4[95% CI：0.0-0.8]mmHg）。经过多变量调整后，在清醒 SBP 水平、睡眠峰值 SBP 或 DBP、清醒和睡眠 SBP 变异性以及睡眠 DBP 变异性的清醒测量值方面，没有证据表明黑人与白人之间存在差异。
与白人参与者相比，黑人参与者的睡眠 SBP 负荷、清醒 DBP ARV 和清醒 DBP 峰值增加更高，独立于 ABPM 上的平均血压。
