Evaluating novel approaches for estimating awake and sleep blood pressure

评估估计清醒和睡眠血压的新方法

• 批准号: 10026029
• 负责人: Paul Muntner
• 金额: $ 4.88万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10026029
• 关键词: Adult; African American; Agreement; Alabama; Albumins; Ambulatory Blood Pressure Monitoring; Antihypertensive Agents; Anxiety; Blood Pressure; Canada; Cardiovascular Diseases; Clinic; Contusions; Creatinine; Data; Development; Devices; Diagnosis; Enrollment; Environment; Fostering; Funding; Goals; Health Personnel; Health behavior; Home Blood Pressure Monitoring; Home environment; Hour; Hypertension; Intervention; Intervention Trial; Left Ventricular Mass; Measurement; Measures; Mercury; Methods; Monitor; New York; Office Visits; Organ; Outcome; Pain; Parents; Participant; Patients; Persons; Pharmaceutical Preparations; Positioning Attribute; Prevalence; Procedures; Protocols documentation; Psychosocial Assessment and Care; Publications; Race; Reference Standards; Research; Research Personnel; Risk; Role; Sleep; Sphygmomanometers; Testing; Time; Training; Universities; Visit; anxiety states; awake; blood pressure intervention; cardiovascular risk factor; diagnosis standard; health disparity; indexing; masked hypertension; monitoring device; novel; novel strategies; psychosocial; recruit; screening; skills; urinary

In the US, hypertension is diagnosed by measuring blood pressure (BP) in the office by a healthcare provider or technician, an approach referred to as attended office BP. However, this approach provides a poor estimate of a person's BP. Ambulatory BP monitoring (ABPM) measures BP automatically every 15 to 30 minutes outside of the office setting typically for 24 hours including while a person is awake and asleep. Although ABPM is considered to be the reference standard for diagnosing hypertension, it is not available in most clinics in the US and, when available, it is not tolerated by many patients. These issues highlight the need for new approaches for diagnosing hypertension. Canadian studies suggest that BP measured in the office using an automatic oscillometric device without an observer being present, an approach referred to as unattended office BP, may be closer to awake BP on ABPM than attended office BP. These finding raise the possibility that factors associated with the office environment such as patient anxiety may contribute to differences between attended and unattended blood pressure. The main objective of the proposed research is to determine the role of state anxiety, or anxiety at a specific moment in time, in the measurement of blood pressure in the office and during sleep. The proposed research will: 1) Determine the association between state anxiety and the difference between office BP measured unattended versus attended, 2) Determine the association between state anxiety at bedtime and sleep BP, and 3) Determine the association between state anxiety in the office and at bedtime and left ventricular mass index. Given the higher levels of sleep BP and increased risk for cardiovascular target organ damage and cardiovascular disease among African Americans compared with whites, we will examine differences in the association between state anxiety and outcomes by race. Through the proposed Investigator Research Supplement the candidate, Dr. Shakia Hardy, has a unique opportunity to test her hypotheses using data being collected from the parent study, Evaluating novel approaches for estimating awake and sleep blood pressure, R01 HL139716, PI Paul Muntner, conducted at the University of Alabama at Birmingham and Columbia University with an established protocol and ongoing participant enrollment. To facilitate this research and foster Dr. Hardy’s path toward independence, she will gain additional training in the measurement and interpretation of blood pressure and subclinical cardiovascular disease, psychosocial determinants of cardiovascular disease, determinants of health disparities, and professional development. Skills and findings obtained from the completion of the training and research aims of this propose will result in scientific presentations and publications, preliminary data to successfully compete for K01 funding, and uniquely position the Dr. Hardy to make important contributions to the study of psychosocial determinants of hypertension and cardiovascular disease.

在美国，高血压是由医疗保健提供者在办公室测量血压（BP）来诊断的 或技术人员，一种称为有人值守办公室BP的方法。然而，这种方法提供了一个贫穷的估计 一个人的BP。动态血压监测（ABPM）每15至30分钟自动测量血压 在办公室环境之外，通常持续24小时，包括人醒着和睡着的时候。虽然 ABPM被认为是诊断高血压的参考标准，但在大多数诊所都无法获得 在美国，当可用时，许多患者不耐受。这些问题突出表明， 诊断高血压的方法。加拿大的研究表明，BP在办公室使用 无人值守的自动测量设备，称为无人值守办公室 在ABPM上，BP可能比在办公室BP更接近清醒BP。这些发现提出了一种可能性， 与办公室环境相关的因素，如患者焦虑，可能导致 有无血压监测拟议研究的主要目标是确定 状态焦虑，或焦虑在特定时刻的时间，在测量血压在办公室， 在睡眠中。本研究将：（1）确定状态焦虑与心理健康之间的关系。 测量的办公室BP无人值守与有人值守之间的差异，2）确定 睡前状态焦虑和睡眠血压，以及3）确定办公室状态焦虑之间的关联 和左心室质量指数。鉴于睡眠血压水平较高， 非裔美国人的心血管靶器官损伤和心血管疾病与 白人，我们将检查状态焦虑和种族结果之间的关联差异。通过 候选人Shakia哈代博士有一个独特的机会， 使用从母研究中收集的数据来测试她的假设， 估计清醒和睡眠血压，R01 HL 139716，PI Paul Muntner，在University of 亚拉巴马大学伯明翰分校和哥伦比亚大学，具有既定方案和持续参与者 招生为了促进这项研究，并促进哈代博士的独立之路，她将获得 测量和解释血压和亚临床心血管疾病的额外培训 心血管疾病的心理社会决定因素，健康差异的决定因素， 专业发展。从完成培训和研究目标中获得的技能和结果 这一提议将导致科学报告和出版物，初步数据，以成功地竞争 K01的资助，以及地位独特的哈代博士为社会心理学的研究做出了重要贡献 高血压和心血管疾病的决定因素。