The effect of race and sleep-disordered breathing on nocturnal BP "dipping" - Analysis in an older population
The effect of race and sleep-disordered breathing on nocturnal BP "dipping" - Analysis in an older population
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DOI：
10.1378/chest.122.4.1148
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发表时间：
2002-10-01
期刊：
影响因子：
9.6
通讯作者：
Johnson, S
中科院分区：
文献类型：
--
作者：
Ancoli-Israel, S;Stepnowsky, C;Johnson, S
研究目标：夜间血压通常下降（或“下降”）约10%；然而，在一些疾病中，夜间血压“不下降”的数量增加。这项研究调查了老年非裔美国人和老年白人受试者不洗澡是否与睡眠呼吸障碍（SDB）和高血压的存在有关。设计：采用方便样本的前瞻性研究。设置：所有数据均在受试者家中收集。参与者：70名自称有打鼾或白天嗜睡症状的非裔美国人，以及70名年龄和性别匹配的白人受试者。测量和结果：记录2晚睡眠，1晚血氧测定。在单独的24小时内记录血压。即使在考虑呼吸障碍指数（RDI）、氧去饱和指数（ODI）、体重指数和24小时平均动脉压等协变量后（p = 0.025），非洲裔美国人的浸出率也高于白人受试者。较高的RDI （R-2 = 0.0686, p = 0.021）和ODI （R-2 = 0.042, p < 0.03）与非裔美国人和白人受试者较高的浸出率相关。然而，存在三向相互作用，较高的rdi主要与接受抗高血压药物治疗的非裔美国人不浸入相关（R-2 = 0.0373, p = 0.022）。结论：这些结果表明，非裔美国人倾向于“不沾水”，而白人则倾向于“沾水”。这种不沾不是体重、性别或患有SDB的结果。分析还证实，在两个种族中，SDB和高血压患者的下降率最大。第三个假设，即RDI在非浸入性高血压受试者中最大，只对非裔美国人成立。
Study objectives: BP normally drops (or "dips") by approximately 10% at nighttime; however, in a number of illnesses there is an increased amount of "nondipping" of nocturnal BP. This study examined whether nondipping in older African Americans and older white subjects is related to the presence of sleep-disordered breathing (SDB) and hypertension.Design: Prospective study with a convenience sample.Setting: All data were collected in the subjects' homes. Participants: Seventy self-defined African Americans with complaints of snoring or excessive daytime sleepiness, and 70 age-matched and gender-matched white subjects.Measurements and results: Sleep was recorded for 2 nights, with I night of oximetry. BP was recorded on a separate 24-h period. African Americans had higher dipping ratios than white subjects even after accounting for covariates such as respiratory disturbance index (RDI), oxygen desaturation index (ODI), body mass index, and average 24-h mean arterial pressure (p = 0.025). Higher values of RDI (R-2 = 0.0686, p = 0.021) and ODI (R-2 = 0.042, p < 0.03) were correlated with higher dipping ratios in both African Americans and white subjects. However, there was a three-way interaction such that higher RDIs were correlated primarily with nondipping in African Americans receiving antihypertensive medication (R-2 = 0.0373, p = 0.022).Conclusions: These results demonstrated that African Americans tend to be "nondippers," while white subjects tended to be "dippers." This nondipping was not a result of weight, gender, or of having SDB. The analyses also confirmed that, in both races, the dipping ratio was greatest in those with SDB and hypertension. The third hypothesis, that RDI would be greatest in the nondipping hypertensive subjects, was true only for the African Americans.