title: Clinic and ambulatory blood pressure in a population-based sample of African Americans: the Jackson Heart Study.
abstract: Blood pressure (BP) can differ substantially when measured in the clinic versus outside of the clinic setting. Few population-based studies with ambulatory blood pressure monitoring (ABPM) include African Americans. We calculated the prevalence of clinic hypertension and ABPM phenotypes among 1016 participants in the population-based Jackson Heart Study, an exclusively African-American cohort. Mean daytime systolic BP was higher than mean clinic systolic BP among participants not taking antihypertensive medication (127.1[standard deviation 12.8] vs. 124.5[15.7] mm Hg, respectively) and taking antihypertensive medication (131.2[13.6] vs. 130.0[15.6] mm Hg, respectively). Mean daytime diastolic BP was higher than clinic diastolic BP among participants not taking antihypertensive medication (78.2[standard deviation 8.9] vs. 74.6[8.4] mm Hg, respectively) and taking antihypertensive medication (77.6[9.4] vs. 74.3[8.5] mm Hg, respectively). The prevalence of daytime hypertension was higher than clinic hypertension for participants not taking antihypertensive medication (31.8% vs. 14.3%) and taking antihypertensive medication (43.0% vs. 23.1%). A high percentage of participants not taking and taking antihypertensive medication had nocturnal hypertension (49.4% and 61.7%, respectively), white-coat hypertension (30.2% and 29.3%, respectively), masked hypertension (25.4% and 34.6%, respectively), and a nondipping BP pattern (62.4% and 69.6%, respectively). In conclusion, these data suggest hypertension may be misdiagnosed among African Americans without using ABPM.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: sjthomas@uab.edu.
authors.forename: S Justin
authors.initials: SJ
authors.lastname: Thomas
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: John N
authors.initials: JN
authors.lastname: Booth
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Samantha G
authors.initials: SG
authors.lastname: Bromfield
authors.affiliation: Center of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Samantha R
authors.initials: SR
authors.lastname: Seals
authors.affiliation: Department of Population Health, New York University School of Medicine, New York City, NY, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Spruill
authors.affiliation: Department of Population Health, New York University School of Medicine, New York City, NY, USA.
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Srividya
authors.initials: S
authors.lastname: Kidambi
authors.affiliation: Department of Medicine, Columbia University, New York City, NY, USA.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Calhoun
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D015331:Cohort Studies; D003951:Diagnostic Errors / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States; D059466:White Coat Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000959:Antihypertensive Agents
keywords: Ambulatory blood pressure monitoring; masked hypertension; nocturnal hypertension; nondipping