Socioeconomic status is associated with nocturnal blood pressure dipping.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Stepnowsky
Carl J
CJ
Department of Psychiatry, University of California, San Diego, San Diego, California, USA. cstepnowsky@ucsd.edu
Nelesen
Richard A
RA
DeJardin
Doug
D
Dimsdale
Joel E
JE
D000328:Adult; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D017286:Polysomnography; D011379:Prognosis; D012044:Regression Analysis; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology; D012923:Social Class; D012931:Social Environment; D044465:White People / Q000706:statistics & numerical data