Does race affect the decline in blood pressure associated with hospitalization in hypertensive and normotensive individuals?
The decline in blood pressure routinely observed during hospitalization is significantly attenuated in black patients compared to white patients, highlighting a racial difference in physiological response to the hospital environment.
Hospitalization routinely lowers blood pressure (BP). This study examined the effects of race and psychologic characteristics on this phenomenon. Data are reported from two separate cohorts of hypertensive and normotensive black and white men and women who were studied following a stay at a clinical research center where sodium intake was held constant. Blacks (N = 88), as compared to whites (N = 77), showed consistently smaller declines in systolic BP (P < .01) following hospitalization (-11.6 mm Hg SBP v -19.5 mm Hg SBP, respectively). A multiple regression model that treated BP as a function of physiologic and psychologic attributes indicated that preadmission BP level, body mass index, stress level, and anger expression were related to the drop in systolic (r2 = 65%) and diastolic (r2 = 45%) BP brought about by hospitalization (P < .0001). In blacks, high environmental stress ratings were unrelated to the change in BP with hospitalization. In contrast, whites with high environmental stress ratings lowered their BP noticeably with hospitalization. Given that the reduction in BP with hospitalization can be similar to that attained with pharmacologic therapy, these findings may have a bearing on studies examining BP in the hospital.
PJ Mills (Wed,) studied this question.