Interplay of Race and Neighborhood Deprivation on Ambulatory Blood Pressure in Young Adults

Abstract

AbstractBackgroundAmbulatory blood pressure (BP) monitoring measures nighttime BP and BP dipping, which are superior to in-clinic BP for predicting cardiovascular disease (CVD), the leading cause of death in America. Compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping, including in young adulthood. Social determinants of health contribute to disparities in CVD risk, but the contribution of neighborhood deprivation on nighttime BP is unclear. Therefore, we examined associations between neighborhood deprivation with nighttime BP and BP dipping in young Black and White adults.MethodsWe recruited 21 Black and 26 White participants (20 M/27 F, mean age: 21 years, body mass index: 25±4 kg/m2) for 24-hour ambulatory BP monitoring. We assessed nighttime BP and BP dipping (nighttime:daytime BP ratio). The area deprivation index (ADI) was used to measure neighborhood deprivation. Associations between ADI and ambulatory BP were examined.ResultsBlack participants exhibited higher nighttime diastolic BP compared with White participants (63±8 mmHg vs 58±7 mmHg,p=0.003), and attenuated BP dipping ratios for both systolic (0.92±0.06 vs 0.86±0.05,p=0.001) and diastolic BP (0.86±0.09 vs 0.78±0.08,p=0.007). Black participants experienced greater neighborhood deprivation compared with White participants (ADI scores: 110±8 vs 97±21,p<0.001), and ADI was associated with attenuated systolic BP dipping (ρ=0.342,p=0.019).ConclusionsOur findings suggest neighborhood deprivation may contribute to higher nighttime BP and attenuated BP dipping, which are prognostic of CVD, and more prevalent in Black adults. Targeted interventions to mitigate the effects of neighborhood deprivation may help to improve nighttime BP.Clinical Trial RegistryURL:https://www.clinicaltrials.gov; Unique identifier:NCT04576338Clinical PerspectiveWe demonstrate young Black adults exhibit higher nighttime blood pressure and attenuated nighttime blood pressure dipping compared with young White adults.Black adults were exposed to greater neighborhood deprivation, which was associated with attenuated blood pressure dipping, irrespective of race.Our findings add to a growing body of literature indicating neighborhood deprivation may contribute to increased cardiovascular disease risk.