title: Socioeconomic position is positively associated with blood pressure dipping among African-American adults: the Jackson Heart Study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Jackson State University, Jackson Heart Study, Jackson, Mississippi, USA. demarc.a.hickson@jsums.edu
authors.forename: Demarc A
authors.initials: DA
authors.lastname: Hickson
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wyatt
authors.forename: Samson Y
authors.initials: SY
authors.lastname: Gebreab
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sarpong
authors.forename: Herman A
authors.initials: HA
authors.lastname: Taylor
authors.forename: Marion R
authors.initials: MR
authors.lastname: Wofford
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012923:Social Class