title: Social support and nocturnal blood pressure dipping: a systematic review.
abstract: BACKGROUND
  Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping.
  
  
  METHODS
  A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours.
  
  
  RESULTS
  A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude.
  
  
  CONCLUSIONS
  Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.
authors: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA. abrewer@projects.sdsu.edu
authors: Addie L
authors: AL
authors: Fortmann
authors: Linda C
authors: LC
authors: Gallo
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D017533:Marital Status; D012890:Sleep / Q000502:physiology; D012944:Social Support
references: Blood Press Monit. 1996 Jun;1(3):217-222
references: 10226230
references: J Hypertens. 1991 Feb;9(2):115-9
references: 1849525
references: J Pers Soc Psychol. 1991 Dec;61(6):1028-39
references: 1774625
references: Int J Psychiatry Clin Pract. 2008;12(4):292-5
references: 24937716
references: Psychosom Med. 2003 Sep-Oct;65(5):746-50
references: 14508015
references: J Health Soc Behav. 2010;51 Suppl:S54-66
references: 20943583
references: Womens Health. 1995 Summer;1(2):161-75
references: 9373378
references: Sleep. 2004 Sep 15;27(6):1097-103
references: 15532203
references: Ann Behav Med. 2012 Dec;44(3):389-98
references: 22777880
references: Blood Press Monit. 2008 Dec;13(6):325-32
references: 18756173
references: Psychosom Med. 2004 Sep-Oct;66(5):651-5
references: 15385687
references: Scand J Work Environ Health. 2013 Jan;39(1):112-9
references: 22460541
references: Stat Med. 2002 Jun 15;21(11):1539-58
references: 12111919
references: JAMA. 1999 Aug 11;282(6):539-46
references: 10450715
references: J Cardiovasc Risk. 1999 Dec;6(6):379-85
references: 10817083
references: Psychosom Med. 2004 May-Jun;66(3):298-304
references: 15184687
references: Hypertension. 2001 Nov;38(5):997-1002
references: 11711488
references: Nurs Clin North Am. 2008 Mar;43(1):133-53; vii-viii
references: 18249229
references: Annu Rev Clin Psychol. 2005;1:255-91
references: 17716089
references: Am J Hypertens. 2011 Sep;24(9):982-8
references: 21633397
references: Psychosom Med. 1987 Jul-Aug;49(4):341-54
references: 3615763
references: Expert Rev Pharmacoecon Outcomes Res. 2010 Dec;10(6):701-5
references: 21155703
references: Can J Cardiol. 2009 Jun;25(6):e157-63
references: 19536383
references: Am J Hypertens. 2000 Aug;13(8):884-91
references: 10950396
references: BMJ. 2000 Apr 22;320(7242):1128-34
references: 10775227
references: Behav Sleep Med. 2009;7(1):2-19
references: 19116797
references: Am J Geriatr Psychiatry. 2009 Feb;17(2):136-43
references: 19155746
references: Psychosom Med. 2009 Jun;71(5):524-31
references: 19321852
references: Psychosom Med. 2010 Apr;72(3):266-72
references: 20124424
references: Hypertension. 1999 May;33(5):1099-104
references: 10334794
references: Am J Hypertens. 2011 Sep;24(9):1015-21
references: 21654853
references: Am J Hypertens. 2002 Feb;15(2 Pt 1):111-8
references: 11863245
references: J Hypertens. 2004 Nov;22(11):2087-93
references: 15480091
references: J Hypertens. 2002 Nov;20(11):2183-9
references: 12409956
references: Ann Behav Med. 2008 Apr;35(2):239-44
references: 18347896
references: J Hum Hypertens. 2010 Nov;24(11):749-54
references: 20200549
references: Psychosom Med. 2008 Jan;70(1):49-56
references: 18158368
references: Circulation. 2005 Apr 12;111(14):1777-83
references: 15809377
references: Hypertension. 2000 Mar;35(3):844-51
references: 10720605
references: Biol Psychiatry. 2003 Dec 15;54(12):1389-98
references: 14675803
references: J Hypertens. 2010 Feb;28(2):265-71
references: 20051909
references: Int J Psychophysiol. 2009 Mar;71(3):211-7
references: 18930771
references: Psychosom Med. 2010 Nov;72(9):842-54
references: 20841557
references: Psychol Bull. 2001 Jul;127(4):472-503
references: 11439708
references: Int J Behav Med. 2008;15(2):73-80
references: 18569125
references: Am J Health Promot. 2008 Mar-Apr;22(4):246-55
references: 18421889
references: Annu Rev Sociol. 2010 Aug 1;36:139-157
references: 21921974
references: Health Psychol. 2010 Mar;29(2):196-204
references: 20230093
references: Psychol Bull. 1985 Sep;98(2):310-57
references: 3901065
references: Public Health Nutr. 2011 Dec;14(12):2166-75
references: 21729473
references: JAMA. 1997 Jun 25;277(24):1940-4
references: 9200634
references: Lancet. 1988 Aug 13;2(8607):397
references: 2899801
references: N Engl J Med. 2006 Jun 1;354(22):2368-74
references: 16738273
references: Psychosom Med. 2008 Jan;70(1):7-12
references: 17991817
references: Clin Exp Hypertens. 2010 Jan;32(2):105-12
references: 20374183
references: J Hum Hypertens. 2012 Jun;26(6):381-7
references: 21544088
references: Hypertension. 2005 Jul;46(1):156-61
references: 15939805
references: Am J Hypertens. 2008 Jul;21(7):826-31
references: 18483473
references: Curr Opin Psychiatry. 2008 Mar;21(2):201-5
references: 18332671
references: J Hum Hypertens. 2009 Oct;23(10):645-53
references: 19225527
references: Am J Hypertens. 2009 Jun;22(6):637-42
references: 19325537
references: Am J Hypertens. 2000 Sep;13(9):1035-8
references: 10981556
references: Psychol Bull. 1996 May;119(3):488-531
references: 8668748
references: Psychosom Med. 2010 Apr;72(3):229-38
references: 20223926
references: Health Psychol. 1999 Jul;18(4):393-402
references: 10431941
references: Psychosom Med. 2005 Jul-Aug;67(4):531-8
references: 16046364
references: Psychosom Med. 2008 Apr;70(3):276-81
references: 18256336
references: Sleep. 2010 Jul;33(7):973-81
references: 20614858
references: Nephrol Dial Transplant. 2003 Mar;18(3):563-9
references: 12584280
references: Psychother Psychosom. 2002 Nov-Dec;71(6):350-6
references: 12411770