TY - JOUR
T1 - Superiority of out-of-office blood pressure for predicting hypertensive heart disease in non-hispanic black adults
AU - Rader, Florian
AU - Franklin, Stanley S.
AU - Mirocha, James
AU - Vongpatanasin, Wanpen
AU - Haley, Robert W.
AU - Victor, Ronald G.
N1 - Funding Information:
The project described was supported by the National Center for Research Resources, Grant UL1RR033176, and is now at the National Center for Advancing Translational Sciences, Grant UL1TR000124. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Dallas Heart Study was funded by the Donald W. Reynolds Foundation and was partially supported by award UL1TR001105 from the National Center for Advancing Translational Sciences of the National Institutes of Health. Further project support was provided by R01HL080582 and The Lincy Foundation (both Dr Victor) and by R01 AG057571 and P30DK079328 to Dr Vongpatanasin. Further support was provided by the National Center for Advancing Translational Sciences Grant UL1TR001881 (James Mirocha).
Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34-1.64 for out-of-office systolic BP and 1.15 [1.04-1.28] for clinic systolic BP; 1.71 [1.43-2.05] for out-of-office diastolic BP, and 1.03 [0.86-1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration - URL: https://www.clinicaltrials.gov. Unique identifier: NCT00344903.
AB - Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34-1.64 for out-of-office systolic BP and 1.15 [1.04-1.28] for clinic systolic BP; 1.71 [1.43-2.05] for out-of-office diastolic BP, and 1.03 [0.86-1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration - URL: https://www.clinicaltrials.gov. Unique identifier: NCT00344903.
KW - Blood pressure monitoring
KW - Cross-sectional study
KW - Hypertension
KW - Hypertrophy
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=85073125612&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073125612&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.119.13542
DO - 10.1161/HYPERTENSIONAHA.119.13542
M3 - Article
C2 - 31522619
AN - SCOPUS:85073125612
SN - 0194-911X
VL - 74
SP - 1192
EP - 1199
JO - Hypertension
JF - Hypertension
IS - 5
ER -