Enhanced blood pressure variability in a high cardiovascular risk group of African Americans: FIT4Life Study

Veerabhadrappa, Praveen; Diaz, Keith M.; Feairheller, Deborah L.; Sturgeon, Kathleen M.; Williamson, Sheara; Crabbe, Deborah L.; Kashem, Abul; Ahrensfield, Debra; Brown, Michael D.

doi:10.1016/j.jash.2010.04.005

« Previous Next »Journal of the American Society of Hypertension
Volume 4, Issue 4 , Pages 187-195, July 2010

Enhanced blood pressure variability in a high cardiovascular risk group of African Americans: FIT4Life Study

Praveen Veerabhadrappa, MD, MS
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
- Corresponding author: Praveen Veerabhadrappa, MD, MS, Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, 1800 N. Broad Street, Philadelphia, PA 19122. Tel: 215-204-0084; fax: 215-204-4414.
Keith M. Diaz, BS
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
Deborah L. Feairheller, BS
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
Kathleen M. Sturgeon, MEd
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
Sheara Williamson, MS
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
Deborah L. Crabbe, MD
- Division of Cardiology, Department of Medicine, Temple University, Philadelphia, PA
- Cardiovascular Research Center, School of Medicine, Temple University, Philadelphia, PA
Abul Kashem, MD, PhD
- Division of Cardiology, Department of Medicine, Temple University, Philadelphia, PA
- Cardiovascular Research Center, School of Medicine, Temple University, Philadelphia, PA
Debra Ahrensfield, MD
- Division of Cardiology, Department of Medicine, Temple University, Philadelphia, PA
Michael D. Brown, PhD
- Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, College of Health Professions, Temple University, Philadelphia, PA
- Cardiovascular Research Center, School of Medicine, Temple University, Philadelphia, PA

Received 9 April 2010; accepted 22 April 2010. published online 31 May 2010.

Abstract

High blood pressure (BP) levels in African Americans elicit vascular inflammation resulting in vascular remodeling. BP variability (BPV) correlates with target organ damage. We aimed to investigate the relationship between inflammatory markers and BPV in African Americans. Thirty-six African Americans underwent 24-hour ambulatory BP monitoring (ABPM). BPV was calculated using the average real variability index. Fasting blood samples were assayed for high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and white blood cell (WBC) count. Significant associations between hs-CRP and 24-hour systolic variability (r = 0.50; P = .012) and awake systolic variability (r = 0.45; P = .02) were identified after adjusting for age, body mass index, and 24-hour mean BP. ABPM variables were compared between the hs-CRP tertile groups. In post-hoc analysis, there was a significant difference in 24-hour and awake periods for both systolic and diastolic variability among the groups. TNF-α and WBC count showed no associations with ABPM variables. hs-CRP was associated with systolic variability, and higher levels of hs-CRP were related with greater BPV. Higher inflammatory status influences wider fluctuations in systolic BP, which in turn could facilitate early progression to target organ damage independent of absolute BP levels in African Americans.

Keywords: Blood pressure variability, high-sensitivity C-reactive protein, African Americans, tumor necrosis factor- alpha, white blood cells, inflammation, ambulatory blood pressure monitoring