January 28, 2019Open Access
View Full PaperHealth Behaviors, Nocturnal Hypertension, and Non-dipping Blood Pressure: The Coronary Artery Risk Development in Young Adults and Jackson Heart Study
Key Result
A composite health behavior score was not significantly associated with nocturnal hypertension (PR 0.96; 95% CI 0.77-1.20 for poor vs very good in CARDIA) or non-dipping systolic blood pressure.
Study Design
Type
Cross-Sectional (n=1,827)
Multicenter
Yes
Structured PICO
Is a composite health behavior score associated with nocturnal hypertension or non-dipping systolic blood pressure?
P
Population
1,827 participants with ambulatory BP monitoring from the Year 30 Coronary Artery Risk Development in Young Adults (CARDIA) study exam (n=781) and the baseline Jackson Heart Study (JHS) exam (n=1,046).
I
Intervention
Composite health behavior score (based on body mass index, physical activity, smoking, and alcohol intake) categorized as good, fair, and poor.
C
Comparator
Very good composite health behavior score.
O
Outcome
Nocturnal hypertension (mean asleep SBP ≥ 120 mm Hg or mean asleep DBP ≥ 70 mm Hg) and non-dipping SBP (< 10% awake-to-asleep decline in SBP).surrogate
A composite score of health behaviors (BMI, physical activity, smoking, alcohol) was not significantly associated with nocturnal hypertension or non-dipping blood pressure patterns.
Main Result
Effect estimate: PR 0.96 (95% CI 0.77-1.20)
Abstract
BACKGROUND: Several health behaviors have been associated with hypertension based on clinic blood pressure (BP). Data on the association of health behaviors with nocturnal hypertension and non-dipping systolic BP (SBP) are limited. METHODS: We analyzed data for participants with ambulatory BP monitoring at the Year 30 Coronary Artery Risk Development in Young Adults (CARDIA) study exam in 2015-2016 (n = 781) and the baseline Jackson Heart Study (JHS) exam in 2000-2004 (n = 1,046). Health behaviors (i.e., body mass index, physical activity, smoking, and alcohol intake) were categorized as good, fair, and poor and assigned scores of 2, 1, and 0, respectively. A composite health behavior score was calculated as their sum and categorized as very good (score range = 6-8), good (5), fair (4), and poor (0-3). Nocturnal hypertension was defined as mean asleep SBP ≥ 120 mm Hg or mean asleep diastolic BP ≥ 70 mm Hg and non-dipping SBP as < 10% awake-to-asleep decline in SBP. RESULTS: Among CARDIA study and JHS participants, 41.1% and 56.9% had nocturnal hypertension, respectively, and 32.4% and 72.8% had non-dipping SBP, respectively. The multivariable-adjusted prevalence ratios (95% confidence interval) for nocturnal hypertension associated with good, fair, and poor vs. very good health behavior scores were 1.03 (0.82-1.29), 0.98 (0.79-1.22), and 0.96 (0.77-1.20), respectively in CARDIA study and 0.98 (0.87-1.10), 0.96 (0.86-1.09), and 0.86 (0.74-1.00), respectively in JHS. The health behavior score was not associated non-dipping SBP in CARDIA study or JHS after multivariable adjustment. CONCLUSIONS: A health behavior score was not associated with nocturnal hypertension or non-dipping SBP.