title: Socioeconomic status, psychosocial factors, race and nocturnal blood pressure dipping in a Hispanic cohort.
abstract: BACKGROUND
  Little information is available about the relationship of socioeconomic status (SES) to blunted nocturnal ambulatory blood pressure (ABP) dipping among Hispanics and whether this relationship differs by race. We sought to characterize ABP nondipping and its determinants in a sample of Hispanics.
  
  
  METHODS
  We enrolled 180 Hispanic participants not on antihypertensive medications. SES was defined by years of educational attainment. All participants underwent 24-hour ABP monitoring. A decrease of <10% in the ratio between average awake and average asleep systolic BP was considered nondipping.
  
  
  RESULTS
  The mean age of the cohort was 67.1 ± 8.7, mean educational level was 9.4 ± 4.4 years, and 58.9% of the cohort was female. The cohort was comprised of 78.3% Caribbean Hispanics with the rest from Mexico and Central/South America; 41.4% self-identified as white Hispanic, 34.4% self-identified as black Hispanic, and 24.4% did not racially self- identify. The percentage of nondippers was 57.8%. Educational attainment (10.5 years vs. 8.6 years; P <0.01) was significantly higher among dippers than nondippers. In multivariable analyses, each 1-year increase in education was associated with a 9% reduction in the likelihood of being a nondipper (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84-0.98; P = 0.01). There were significantly greater odds of being a nondipper for black Hispanics than for white Hispanics (OR, 2.83, 95% CI, 1.29-6.23; P = 0.005). Higher SES was significantly protective of nondipping in white Hispanics but not black Hispanics.
  
  
  CONCLUSIONS
  These results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation.
authors.affiliation: Department of Medicine and Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA. crodrigu@wakehealth.edu
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Rodriguez
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.forename: Daniel
authors.initials: D
authors.lastname: Turner-Lloveras
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
mesh_terms: D000368:Aged; D044383:Black People; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D017691:Caribbean Region; D002489:Central America; D002940:Circadian Rhythm / Q000502:physiology*; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011584:Psychology; D044469:Racial Groups; D012923:Social Class; D013020:South America; D044465:White People
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