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Metabolic syndrome and masked hypertension among African Americans: The Jackson Heart Study

Lisandro D Colantonio1, D Edmund Anstey2, April P Carson1

  • 1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|February 7, 2017
PubMed

Insights

Metabolic syndrome is linked to masked hypertension (MHT) in African Americans. However, screening for MHT should rely on clinic blood pressure, not metabolic syndrome components.

Area of Science:

  • Cardiovascular Health
  • Metabolic Disorders
  • Hypertension Research

Background:

  • Metabolic syndrome is a cluster of conditions increasing cardiovascular risk.
  • Higher ambulatory blood pressure is linked to metabolic syndrome.
  • Masked hypertension (MHT) presents a diagnostic challenge, particularly in specific populations.

Purpose of the Study:

  • To investigate the association between metabolic syndrome and masked hypertension (MHT) in African Americans.
  • To determine if components of metabolic syndrome are independently associated with MHT.
  • To inform screening strategies for MHT in this demographic.

Main Methods:

  • The study analyzed data from the Jackson Heart Study.
  • Participants with clinic-measured systolic/diastolic blood pressure (SBP/DBP) <140/90 mm Hg were assessed.
  • Masked hypertension was defined using ambulatory blood pressure monitoring (ABPM) criteria.
  • Metabolic syndrome and its individual components were evaluated for association with MHT.

Main Results:

  • Metabolic syndrome was associated with MHT in participants not on medication (PR, 1.38).
  • Only elevated clinic SBP/DBP (130-139/85-89 mm Hg) was independently associated with MHT (PR, 1.90).
  • No association was found between metabolic syndrome and MHT in participants on medication or with lower clinic BP levels.

Conclusions:

  • Ambulatory blood pressure monitoring screening for MHT in African Americans should be guided by clinic blood pressure readings.
  • Metabolic syndrome alone is not a sufficient indicator for MHT screening.
  • Clinical BP thresholds, particularly borderline elevations, are more predictive of MHT than the overall metabolic syndrome diagnosis.

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