title: Nocturnal Non-dipping Blood Pressure Profile in Black Normotensives Is Associated with Cardiac Target Organ Damage.
abstract: OBJECTIVE
  A non-dipping pattern of nocturnal blood pressure in hypertensive patients is an established predictor of cardiovascular risk, especially in Blacks. However, data on non-dipping normotensives and cardiovascular risk in this population is sparse. In this study, we aim to determine if a non-dipping profile in a cohort of Black normotensives is associated with cardiac target organ damage.
  
  
  METHODS
  We studied ambulatory blood pressure patterns in 43 normotensive Black patients of Caribbean origin and classified their profiles as dippers (DP) and non-dippers (NDP) based on their nocturnal blood pressure profiles. Cardiac target organ damage was estimated from 2-D echocardiogram.
  
  
  RESULTS
  The mean age of the cohort was 52 years. Both groups were similar with respect to baseline age, sex, weight, height, body mass index and daytime ambulatory BP. There was a statistically significant difference in nocturnal blood pressure between DP and NDP groups (112 ± 7/64 ± 2 mm Hg vs 117 ± 3/69 ± 2 mm Hg, P=.004). The NDP cohort showed evidence of cardiovascular target damage on echocardiography with a significantly increased relative wall thickness (.35 ± .07 cm vs .42 ± .05 cm, P=.001), left ventricular mass index (95 ± 14 vs 105 ± 14 g/m(2), P=.018) and left atrial volume index (26 ± 3.5 vs. 30 ± 3.4, P=.001). Left ventricular geometry in the non-dippers also showed increased concentric remodeling, concentric and eccentric hypertrophy.
  
  
  CONCLUSIONS
  Our study demonstrates that nocturnal non-dipping of blood pressure in normotensive Blacks of Caribbean origin may be associated with cardiovascular end organ damage thereby providing new surveillance and therapeutic targets.
authors.affiliation: Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Kenechukwu
authors.initials: K
authors.lastname: Mezue
authors.affiliation: DOCS Heart Center, Enugu, Nigeria.
authors.forename: Godsent
authors.initials: G
authors.lastname: Isiguzo
authors.affiliation: University of Virginia School of Medicine, Charlottesville, Virginia, USA.
authors.forename: Chichi
authors.initials: C
authors.lastname: Madu
authors.affiliation: DOCS Heart Center, Enugu, Nigeria.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Nwuruku
authors.affiliation: Delaware Valley Nephrology and Hypertension Associates, Philadelphia; Sidney Kimmel College of Thomas Jefferson University, Philadelphia.
authors.forename: Janani
authors.initials: J
authors.lastname: Rangaswami
authors.affiliation: DOCS Heart Center, Enugu, Nigeria; Heart Institute of the Caribbean (HIC), Kingston, Jamaica.
authors.forename: Dainia
authors.initials: D
authors.lastname: Baugh
authors.affiliation: DOCS Heart Center, Enugu, Nigeria; Heart Institute of the Caribbean (HIC), Kingston, Jamaica.
authors.forename: Ernest
authors.initials: E
authors.lastname: Madu
mesh_terms: D001741:Black or African American; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002319:Cardiovascular System / Q000473:pathology*; D017691:Caribbean Region; D002940:Circadian Rhythm; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged
keywords: Black Population; Cardiac Remodeling; Caribbean Population; Nocturnal Hypertension; Non-dipping Blood Pressure