title: Correlates of isolated nocturnal hypertension and target organ damage in a population-based cohort of African Americans: the Jackson Heart Study.
abstract: BACKGROUND
  African Americans have higher rates of nocturnal hypertension and less nocturnal blood pressure (BP) dipping compared with whites. Although nocturnal hypertension is associated with increased cardiovascular morbidity and mortality, its clinical significance among those with normal daytime BP is unclear. This paper reports the prevalence and correlates of isolated nocturnal hypertension (INH) in a population-based cohort of African Americans enrolled in the Jackson Heart Study (JHS).
  
  
  METHODS
  The study sample included 425 untreated, normotensive and hypertensive JHS participants who underwent 24-hour ambulatory BP monitoring (ABPM), echocardiography, and 24-hour urine collection. Multiple logistic regression and 1-way analysis of variance models were used to test the hypothesis that those with INH have worse target organ damage reflected by greater left ventricular (LV) mass and proteinuria compared with normotensive participants.
  
  
  RESULTS
  Based on 24-hour ABP profiles, 19.1% of participants had INH. In age and sex-adjusted models, participants with INH had greater LV mass compared with those who were normotensive (P = 0.02), as well as about 3 times the odds of LV hypertrophy and proteinuria (Ps < 0.10). However, multivariable adjustment reduced the magnitude and statistical significance of each of these differences.
  
  
  CONCLUSIONS
  INH was associated with increased LV mass compared with normo tension in a population-based cohort of African Americans enrolled in the JHS. There were trends toward a greater likelihood of LV hyper trophy and proteinuria among participants with INH vs. those who were normotensive. The clinical significance of the noted target organ damage should be explored in this population.
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, NY, USA. olugbenga.ogedegbe@nyumc.org
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Spruill
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sarpong
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
authors.forename: William
authors.initials: W
authors.lastname: Chaplin
authors.forename: Amy
authors.initials: A
authors.lastname: Pastva
authors.forename: David
authors.initials: D
authors.lastname: Martins
authors.forename: Joseph
authors.initials: J
authors.lastname: Ravenell
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Pickering
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D002940:Circadian Rhythm; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000453:epidemiology*; D055815:Young Adult
keywords: Jackson Heart Study; ambulatory blood pressure monitoring; blood pressure; hypertension; nocturnal blood pressure; target organ damage.