title: Marital status, dipping and nocturnal blood pressure: results from the Dietary Approaches to Stop Hypertension trial.
abstract: OBJECTIVE
  Blood pressure normally declines during the night ('dipping'); a blunted nocturnal decline is an important cardiovascular risk factor. Marriage may be associated with lower ambulatory blood pressure, although this may be confounded by socio-economic and dietary factors. We examined the association of marital status with nocturnal dipping and night-time SBP amongst individuals on a controlled diet.
  
  
  METHODS
  We analysed 325 individuals enrolled in the Dietary Approaches to Stop Hypertension trial who had available 24-h SBP data and who ingested a control diet. Logistic and linear regression models were fit to estimate the association of marital status with nocturnal dipping and mean night-time SBP.
  
  
  RESULTS
  Of the 325 individuals, 52.9% were men, the average age was 45.1 years and 48.9% reported being married. Compared with nonmarried individuals, those who were married had greater adjusted odds of dipping [odds ratio (OR) 2.26; 95% confidence interval (CI) 1.26-4.03; P = 0.01]. In adjusted models, being married was associated with lower night-time SBP (-2.4  mmHg; 95% CI -3.8 to -0.9  mmHg; P = 0.002), with the suggestion of a greater association in married men compared with married women (-3.1 vs. -1.7  mmHg); there was less difference for married nonblacks compared with married blacks (-2.7 and -2.4  mmHg, respectively).
  
  
  CONCLUSIONS
  Being married is independently associated with a greater likelihood of nocturnal dipping and with lower night-time SBP among individuals participating in a controlled dietary intervention; the association was particularly strong in married men. Marital status is a variable that may be considered in future analyses of ambulatory blood pressure.
authors: aRenal Division, Department of Medicine, Brigham and Women's Hospital bHarvard Medical School cDepartment of Medicine, Brigham and Women's Hospital dDepartment of Nutrition, Harvard School of Public Health eChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: Finnian R Mc
authors: FR
authors: Causland
authors: Frank M
authors: FM
authors: Sacks
authors: John P
authors: JP
authors: Forman
mesh_terms: D000328:Adult; D001741:Black or African American; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D015331:Cohort Studies; D004032:Diet; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D016014:Linear Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents