Key result
Black race was associated with 2.6 times higher odds of worse nocturnal dipping status compared to White race in patients with diabetic kidney disease (OR 2.6; 95% CI 1.2-5.8).
Why the study?
Is black race associated with abnormal nocturnal blood pressure dipping compared to white race in patients with diabetic kidney disease?
Observational (n=108)
Is black race associated with abnormal nocturnal blood pressure dipping compared to white race in patients with diabetic kidney disease?
Black patients with diabetic kidney disease have a 2.6-fold higher odds of abnormal nocturnal blood pressure dipping compared to white patients, highlighting the potential importance of ambulatory BP monitoring in this high-risk group.
Supports race-informed nocturnal BP assessment in diabetic kidney disease; hypothesis-generating for targeted interventions.
While racial variation in ambulatory blood pressure (BP) is known, patterns of diurnal dipping in the context of diabetic kidney disease have not been well defined. The authors sought to determine the association of race with nocturnal dipping status among participants with diabetic kidney disease enrolled in the STOP-DKD (Simultaneous Risk Factor Control Using Telehealth to Slow Progression of Diabetic Kidney Disease) trial. The primary outcome was nocturnal dipping-percent decrease in average systolic BP from wake to sleep-with categories defined as reverse dippers (decrease <0%), nondippers (0%-<10%), and dippers (≥10%). Twenty-four-hour ambulatory BP monitoring was completed by 108 participants (54% were nondippers, 24% were dippers, and 22% were reverse dippers). In adjusted models, the common odds of reverse dippers vs nondippers/dippers and reverse dippers/nondippers vs dippers was 2.6 (95% confidence interval, 1.2-5.8) times higher in blacks than in whites. Without ambulatory BP monitoring data, interventions that target BP in black patients may be unable to improve outcomes in this high-risk group.
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Zullig et al. (2017) conducted an observational in Diabetic kidney disease (n=108). Black race vs. White race was evaluated on Nocturnal dipping status (percent decrease in average systolic BP from wake to sleep, categorized as reverse dippers, nondippers, and dippers) (OR 2.6, 95% CI 1.2-5.8). Black race was associated with 2.6 times higher odds of worse nocturnal dipping status compared to White race in patients with diabetic kidney disease (OR 2.6; 95% CI 1.2-5.8).
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