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Ethnic differences in circadian hemodynamic profile

D D Gretler1, M T Fumo, K S Nelson

  • 1Department of Medicine, University of Chicago, Illinois.

American Journal of Hypertension
|January 1, 1994
PubMed
Summary
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Black individuals exhibit a blunted nocturnal blood pressure decline compared to white individuals. This difference in 24-hour ambulatory blood pressure monitoring (ABPM) may contribute to higher rates of target organ damage in Black populations.

Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Ethnic Health Disparities

Background:

  • Ambulatory blood pressure monitoring (ABPM) reveals potential ethnic differences in nocturnal blood pressure decline.
  • A blunted nocturnal blood pressure fall in Black versus White subjects has been suggested, potentially explaining higher target organ damage rates in Black individuals.

Purpose of the Study:

  • To investigate ethnic differences in diurnal hemodynamic profiles using 24-hour ambulatory blood pressure monitoring (ABPM).
  • To define ethnic variations in blood pressure regulation between Black and White individuals.

Main Methods:

  • ABPM recordings were analyzed from 275 previously untreated Black and 246 White subjects (ages 20-79).
  • Clinic and ABPM systolic and diastolic blood pressures, as well as heart rate, were compared between ethnic groups.

Related Experiment Videos

  • Diurnal changes (awake minus sleep values) in blood pressure were calculated and correlated with baseline levels and race.

    • Main Results:

    • Black subjects exhibited higher average blood pressure values on ABPM, with a greater difference during sleep (9.4 mm Hg systolic) than while awake (4.7 mm Hg systolic).
    • The average diurnal change in systolic blood pressure was significantly lower in Black individuals (13.1 mm Hg) compared to White individuals (18.0 mm Hg).
    • A smaller nocturnal blood pressure fall in Black individuals was observed, independent of higher baseline blood pressure levels, suggesting an effect of race.

    Conclusions:

    • The smaller diurnal blood pressure variation in Black individuals is partly related to higher blood pressure levels but also influenced by an independent effect of race.
    • This results in a greater 24-hour blood pressure load in Black individuals for a given clinic blood pressure value.
    • Diurnal blood pressure profiles should be considered alongside clinic readings in future studies of target organ damage across different populations.