Key result
African American women had a persistently smaller proportional decline in systolic (P<0.038) and diastolic (P<0.083) awake-sleep blood pressure over 3 months compared to European American women.
Why the study?
Does the proportional awake-sleep blood pressure decline differ reproducibly between African American and European American normotensive women over time?
Observational (n=139)
Does the proportional awake-sleep blood pressure decline differ reproducibly between African American and European American normotensive women over time?
p-value: p=<0.038
The study demonstrates that the smaller proportional awake-sleep blood pressure decline observed in African American women compared to European American women is a reproducible phenomenon over time.
Reproducible ethnic BP dipping differences merit prospective outcome studies; should not yet change practice in normotensive women.
A growing body of evidence indicates that African Americans (AA), on average, have a smaller proportional decline in blood pressure (BP) from waking to sleep than European Americans (EA), but this difference is largely based on correlational data from a single assessment day. The persistence of this difference over repeated sampling is not well established. The purpose of this study was to evaluate whether ethnic differences in the awake-sleep BP decline between AA and EA persisted over three monthly assessments. The subjects were 47 AA (age = 39.7 +/- 8.7) and 92 EA (age = 37.4 +/- 9.2) normotensive women. Subjects had 24-h ambulatory BP monitoring done on midweek workdays at 1-month intervals for three consecutive months. The proportional decline in BP was calculated as follows: (average awake - average sleep)/average sleep. The persistence of ethnic differences was evaluated using repeated-measures ANCOVA and by examining Bland-Altman plots. The ANCOVA results revealed that overall, the proportional decline of AA women was less than that of EA women for both SBP (P < 0.038) and DBP (P < 0.083), consistent with previous research, and that there were also no significant ethnic differences by monthly assessment. Bland-Altman plots revealed that overall and by ethnicity, the proportional decline in BP among individual subjects over the 3 months was also reproducible. These results suggest that the ethnic difference in awake-sleep BP between AA and EA women persists over time and that the awake-sleep decline in BP among individuals, whether AA or EA, is also reproducible.
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Berge‐Landry et al. (2009) conducted an observational in Normotension (n=139). African American ethnicity vs. European American ethnicity was evaluated on Proportional decline in systolic blood pressure from waking to sleep (p=<0.038). African American women had a persistently smaller proportional decline in systolic (P<0.038) and diastolic (P<0.083) awake-sleep blood pressure over 3 months compared to European American women.
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