RACE, SOCIOECONOMIC STATUS, AND DIURNAL BLOOD PRESSURE RHYTHMS

本研究旨在调查我们的观察， 两组血压节律不同 在纽约的两个医疗中心， 约克市（纽约医院-康奈尔和哈莱姆医院），分开 地理上只有几英里，但服务非常不同 人口。哈莱姆高血压患者夜间血压下降减少 压力（“非浸渍”模式）。血压模式并没有 在两组相应的血压正常人群中有所不同。哈莱姆高血压患者 社会经济地位低于其他三组。主要 这项研究的目的是检验这一假设，即 是社会心理因素的结果，包括 社会经济地位，职业压力和家庭压力，通过 (a)白天对BP的影响，和/或（B）对睡眠和BP的影响 在晚上。600名血压正常和高血压的黑人和白色 两所院校的课程将采用相同的教学程序。 这将包括24小时血压和活动记录， (day和夜间）24小时尿液收集皮质醇，儿茶酚胺， 等等，和家庭多导睡眠图专家将评估社会心理 和人口统计学因素，以及靶器官损伤将通过以下方式进行评估： 超声心动图、数字化心电图、踝臂指数，以及 微量白蛋白尿社区环境对 还将评估血压模式。有人建议 在黑人高血压患者中常见的非浸渍模式可以 对他们的预后有不利影响，我们将血压 心脏靶器官损伤的不同测量模式， 肾脏

This study is designed to investigate our observation that the diurnal rhythm of blood pressure is different in two groups of black hypertensive patients studied under a common protocol at two medical centers in New York City (New York Hospital-Cornell and Harlem Hospital), separated geographically by only a few miles, but serving very different populations. Harlem hypertensive had a diminished nocturnal fall of blood pressure (' a 'non-dipping' pattern). The blood pressure pattern did not differ in two corresponding groups of normotensives. Harlem hypertensives had lower socioeconomic status than the other 3 groups. The major objective of the study is to test the hypothesis that the difference seen in the hypertensives is the result of psychosocial factors, including socioeconomic status, occupational stress, and domestic stress, acting via (a) effects on BP during the day, and/or (b) effects on sleep and BP during the night. 600 normotensive and hypertensive black and white subjects will be studied at the two institutions with a common protocol. This will include a 24 hour blood pressure and activity recording, split (day and night) 24 hour urine collection for cortisol, catecholamines, etc., and home polysomnography. Questionnaires will evaluate psychosocial and demographic factors, and target organ damage will be assessed by echocardiography, digitized electrocardiography, ankle arm index, and micro-albuminuria. The possible effects of neighborhood environments on blood pressure patterns will also be evaluated. It has been suggested that the non-dipping pattern commonly seen in black hypertensive patens may adversely affect their prognosis, and we will related the blood pressure patterns to the different measures of target organ damage in the heart and kidneys.