Background: Ambulatory blood pressure monitoring (ABPM) can detect hypertension phenotypes associated with increased risk for chronic kidney disease (CKD) progression. There is a high prevalence of these phenotypes in the general population; however, it is unclear whether they are more common among African Americans (AAs) with versus without CKD.
Methods: We examined the prevalence of daytime, nocturnal, white-coat, masked, and sustained hypertension and a non-dipping BP pattern among AAs participating in the Jackson Heart Study. Analyses were restricted to 561 participants taking antihypertensive medication with a complete ABPM recording at baseline (2000-2004). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 or the presence of kidney damage indicated by the presence of albumin-creatinine ratio ≥30 mg/g. We used log binomial regression models in a multivariable adjusted model to calculate the association between CKD and ABPM phenotypes.
Results: The mean age of participants included in the current analysis was 62 years, 72% were female, and 26% had CKD. Daytime, nocturnal, masked, and sustained hypertension and non-dipping were more common, while white-coat hypertension was less common, among participants with versus without CKD (Table 1). The prevalence of sustained hypertension was 1.46-fold (CI 1.03-2.06) greater among those with CKD compare to those without after multivariable adjustment.
Conclusions: In a large community-based study of AAs, ABPM phenotypes were common among adults with CKD. Sustained hypertension was statistically significantly higher in those with versus without CKD.