Abstract
Background
Blunted nocturnal blood pressure (BP) dipping is an early marker of cardiovascular risk that is prevalent among African Americans.
Purpose
We evaluated relationships of BP dipping to neighborhood and posttraumatic stress and sleep in urban residing young adult African Americans.
Methods
One hundred thirty-six black, predominately African American, men and women with a mean age of 22.9 years (SD = 4.6) filled out surveys and were interviewed and had two, 24-h ambulatory BP recordings.
Results
Thirty-eight percent had BP dipping ratios < .10. Wake after sleep onset (WASO), neighborhood disorder and neighborhood poverty rates but not posttraumatic stress symptoms, and other sleep measures correlated significantly with dipping ratios. Models with the neighborhood measures that also included WASO increased the explained variance.
Conclusions
Studies elucidating mechanisms underlying effects of neighborhoods on BP dipping and the role of disrupted sleep, and how they can be mitigated are important directions for future research.
References
Center for Disease Control and Prevention. CDC health disparities and inequalities report - United States, 2011. Atlanta, GA; 2011.
Li S, Chen W, Srinivasan SR, Berenson GS. Childhood blood pressure as a predictor of arterial stiffness in young adults. the Bogalusa heart study. Hypertension. 2004; 43: 541-546.
Ohkubo T, Hozawa A, Yamaguchi J, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: The Ohasama study. J Hypertens. 2002; 20: 2183-2189.
Profant J, Dimsdale J. Race and diurnal blood pressure patterns: A review and meta-analysis. Hypertension. 1999; 33: 1099-1104.
Wilson D, Kliewer W, Teasley N, et al. Violence exposure, catecholamine excretion, and blood pressure nondipping status in African American male versus female adolescents. Psychosom Med. 2002; 64: 906-915.
Do DP, Finch BK, Basurto-Davila R, et al. Does place explain racial health disparities? quantifying the contribution of residential context to the Black/white health gap in the United States. Soc Sci Med. 2008; 67(8): 1258-1268.
Euteneuer F, Mills PJ, Pung MA, et al. Neighborhood problems and nocturnal blood pressure dipping. Health Psychol. 2013; 18.
Mellman TA, Brown D, Hipolito M, et al. Posttraumatic stress disorder and nocturnal blood pressure dipping in young adult African Americans. Psychosom Med. 2009; 71: 627-630.
Kubzansky LD, Koenen KC, Spiro A, et al. Prospective study of post-traumatic stress disorder symptoms and coronary heart disease in the normative aging study. Arch Gen Psychiatry. 2007; 64: 109-116.
Ayas NT, White DP, Manson JE, et al. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003; 163: 205-209.
Vgontzas AN, Liao D, Bixler EO, et al. Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep. 2009; 32(4): 491-497.
Sherwood A, Routledge FS, Wohlgemuth WK, et al. Blood pressure dipping: Ethnicity, sleep quality, and sympathetic nervous system activity. Am J Hypertens. 2011; 24(9): 982-988.
Gillespie CF, Bradley B, Mercer K, et al. Trauma exposure and stress-related disorders in inner city primary care patients. Gen Hosp Psychiatry. 2009; 31(6): 505-514.
Roberts AL, Gilman SE, Breslau J. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med. 2011; 41(1): 71-83.
Hale L, Do DP. Racial differences in self-reports of sleep duration in a population-based study. Sleep. 2007; 30: 1096-1103.
Ewart CK, Suchday S. Discovering how urban poverty and violence affect health: Development and validation of a neighborhood stress index. Health Psychol. 2002; 21(3): 254-262.
Morin CM, Belleville G, Belanger L, Ivers H. The insomnia severity index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2001; 34(5): 601-608.
Weathers FW, Keane TM, Davidson JRT. Clinician-administered PTSD scale: A review of the first ten years of research. Depress Anxiety. 2001; 13: 132-156.
First M, Spitzer R, Miriam G, Williams J. Structured clinical interview for DSM-IV axis I disorders. Washington, DC: American Psychiatric Press; 1996.
Means MK, Edinger JD, Glenn DM, Fins AI. Accuracy of sleep perceptions among insomnia sufferers and normal sleepers. Sleep Med. 2003; 4: 285-96.
Kim YM. Minorities in Higher Education: Twenty-Fourth Status Report. Washington, DC; American Council on Education; 2011.
Acknowledgments
This study was supported by NHLBI grant 5R01HL087995 to Dr. Mellman, and NCRR grant 1UL1RR031975, now NCATS grant UL1TR000101 for the Georgetown Howard Universities Center for Clinical and Translational Science. The authors wish to thank Janeese Brownlow, PhD, Ed Huntley, PhD, and the nursing staff of the Howard University Clinical Research Unit for their assistance.
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards
Thomas Mellman received a consulting fee from Tonix Pharmaceuticals during the past 2 years. Drs. Hall Brown, Kobayashi, Abu-Bader, and Randall, and Mr. Lavela, and Ms. Altaee and McLaughlin have no potential conflicts of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Mellman, T.A., Brown, T.S.H., Kobayashi, I. et al. Blood Pressure Dipping and Urban Stressors in Young Adult African Americans. ann. behav. med. 49, 622–627 (2015). https://doi.org/10.1007/s12160-014-9684-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12160-014-9684-x