Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure
Background Nocturnal hypertension, defined by a mean asleep systolic blood pressure (SBP)/diastolic blood pressure (BP) ≥120/70 mm Hg, and nondipping SBP, defined by an awake‐to‐asleep decline in SBP <10%, are each associated with increased risk for cardiovascular disease. Methods and Results We...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013696 |
| _version_ | 1818289505210204160 |
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| author | Byron C. Jaeger John N. Booth Mark Butler Lloyd J. Edwards Cora E. Lewis Donald M. Lloyd‐Jones Swati Sakhuja Joseph E. Schwartz James M. Shikany Daichi Shimbo Yuichiro Yano Paul Muntner |
| author_facet | Byron C. Jaeger John N. Booth Mark Butler Lloyd J. Edwards Cora E. Lewis Donald M. Lloyd‐Jones Swati Sakhuja Joseph E. Schwartz James M. Shikany Daichi Shimbo Yuichiro Yano Paul Muntner |
| author_sort | Byron C. Jaeger |
| collection | DOAJ |
| description | Background Nocturnal hypertension, defined by a mean asleep systolic blood pressure (SBP)/diastolic blood pressure (BP) ≥120/70 mm Hg, and nondipping SBP, defined by an awake‐to‐asleep decline in SBP <10%, are each associated with increased risk for cardiovascular disease. Methods and Results We developed predictive equations to identify adults with a high probability of having nocturnal hypertension or nondipping SBP using data from the CARDIA (Coronary Artery Risk Development in Young Adults) study (n=787), JHS (Jackson Heart Study) (n=1063), IDH (Improving the Detection of Hypertension) study (n=395), and MHT (Masked Hypertension) study (n=772) who underwent 24‐hour ambulatory BP monitoring. Participants were randomized to derivation (n=2511) or validation (n=506) data sets. The prevalence rates of nocturnal hypertension and nondipping SBP were 39.7% and 44.9% in the derivation data set, respectively, and 36.6% and 44.5% in the validation data set, respectively. The predictive equation for nocturnal hypertension included age, race/ethnicity, smoking status, neck circumference, height, high‐density lipoprotein cholesterol, albumin/creatinine ratio, and clinic SBP and diastolic BP. The predictive equation for nondipping SBP included age, sex, race/ethnicity, waist circumference, height, alcohol use, high‐density lipoprotein cholesterol, and albumin/creatinine ratio. Concordance statistics (95% CI) for nocturnal hypertension and nondipping SBP predictive equations in the validation data set were 0.84 (0.80–0.87) and 0.73 (0.69–0.78), respectively. Compared with reference models including antihypertensive medication use and clinic SBP and diastolic BP as predictors, the continuous net reclassification improvement (95% CI) values for the nocturnal hypertension and nondipping SBP predictive equations were 0.52 (0.35–0.69) and 0.51 (0.34–0.69), respectively. Conclusions These predictive equations can direct ambulatory BP monitoring toward adults with high probability of having nocturnal hypertension and nondipping SBP. |
| first_indexed | 2024-12-13T02:13:20Z |
| format | Article |
| id | doaj.art-5ad6ccc5efa048a28622cbf8e4542199 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:13:20Z |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-5ad6ccc5efa048a28622cbf8e45421992022-12-22T00:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-01-019210.1161/JAHA.119.013696Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood PressureByron C. Jaeger0John N. Booth1Mark Butler2Lloyd J. Edwards3Cora E. Lewis4Donald M. Lloyd‐Jones5Swati Sakhuja6Joseph E. Schwartz7James M. Shikany8Daichi Shimbo9Yuichiro Yano10Paul Muntner11Department of Biostatistics University of Alabama at Birmingham ALDepartment of Epidemiology University of Alabama at Birmingham ALDepartment of Population Health Sciences New York University School of Medicine New York NYDepartment of Biostatistics University of Alabama at Birmingham ALDepartment of Epidemiology University of Alabama at Birmingham ALDepartment of Preventive Medicine Northwestern University Evanston ILDepartment of Epidemiology University of Alabama at Birmingham ALDepartment of Psychiatry Stony Brook School of Medicine Stony Brook NYDivision of Preventive Medicine Department of Medicine University of Alabama at Birmingham ALDepartment of Medicine Columbia University Medical Center New York NYDepartment of Community and Family Medicine Duke University Durham NCDepartment of Epidemiology University of Alabama at Birmingham ALBackground Nocturnal hypertension, defined by a mean asleep systolic blood pressure (SBP)/diastolic blood pressure (BP) ≥120/70 mm Hg, and nondipping SBP, defined by an awake‐to‐asleep decline in SBP <10%, are each associated with increased risk for cardiovascular disease. Methods and Results We developed predictive equations to identify adults with a high probability of having nocturnal hypertension or nondipping SBP using data from the CARDIA (Coronary Artery Risk Development in Young Adults) study (n=787), JHS (Jackson Heart Study) (n=1063), IDH (Improving the Detection of Hypertension) study (n=395), and MHT (Masked Hypertension) study (n=772) who underwent 24‐hour ambulatory BP monitoring. Participants were randomized to derivation (n=2511) or validation (n=506) data sets. The prevalence rates of nocturnal hypertension and nondipping SBP were 39.7% and 44.9% in the derivation data set, respectively, and 36.6% and 44.5% in the validation data set, respectively. The predictive equation for nocturnal hypertension included age, race/ethnicity, smoking status, neck circumference, height, high‐density lipoprotein cholesterol, albumin/creatinine ratio, and clinic SBP and diastolic BP. The predictive equation for nondipping SBP included age, sex, race/ethnicity, waist circumference, height, alcohol use, high‐density lipoprotein cholesterol, and albumin/creatinine ratio. Concordance statistics (95% CI) for nocturnal hypertension and nondipping SBP predictive equations in the validation data set were 0.84 (0.80–0.87) and 0.73 (0.69–0.78), respectively. Compared with reference models including antihypertensive medication use and clinic SBP and diastolic BP as predictors, the continuous net reclassification improvement (95% CI) values for the nocturnal hypertension and nondipping SBP predictive equations were 0.52 (0.35–0.69) and 0.51 (0.34–0.69), respectively. Conclusions These predictive equations can direct ambulatory BP monitoring toward adults with high probability of having nocturnal hypertension and nondipping SBP.https://www.ahajournals.org/doi/10.1161/JAHA.119.013696ambulatoryblood pressurenocturnal hypertensionnondippingpredictive equationvalidation |
| spellingShingle | Byron C. Jaeger John N. Booth Mark Butler Lloyd J. Edwards Cora E. Lewis Donald M. Lloyd‐Jones Swati Sakhuja Joseph E. Schwartz James M. Shikany Daichi Shimbo Yuichiro Yano Paul Muntner Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease ambulatory blood pressure nocturnal hypertension nondipping predictive equation validation |
| title | Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure |
| title_full | Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure |
| title_fullStr | Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure |
| title_full_unstemmed | Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure |
| title_short | Development of Predictive Equations for Nocturnal Hypertension and Nondipping Systolic Blood Pressure |
| title_sort | development of predictive equations for nocturnal hypertension and nondipping systolic blood pressure |
| topic | ambulatory blood pressure nocturnal hypertension nondipping predictive equation validation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013696 |
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