Search

There is limited empirical evidence to support the protective effects of physical activity in the prevention of hypertension among African Americans. The purpose of this study was to examine the association of physical activity with incident hypertension among African Americans. We studied 1311 participants without hypertension at baseline enrolled in the Jackson Heart Study, a community-based study of African Americans residing in Jackson, Mississippi. Overall physical activity, moderate-vigorous physical activity, and domain-specific physical activity (work, active living, household, and sport/exercise) were assessed by self-report during the baseline examination (2000-2004). Incident hypertension, assessed at examination 2 (2005-2008) and examination 3 (2009-2013), was defined as the first visit with systolic/diastolic blood pressure ≥140/90 mm Hg or self-reported antihypertensive medication use. Over a median follow-up of 8.0 years, there were 650 (49.6%) incident hypertension cases. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with intermediate and ideal versus poor levels of moderate-vigorous physical activity were 0.84 (0.67-1.05) and 0.76 (0.58-0.99), respectively ( P trend=0.038). A graded, dose-response association was also present for sport/exercise-related physical activity (Quartiles 2, 3, and 4 versus Quartile 1: 0.92 [0.68-1.25], 0.87 [0.67-1.13], 0.75 [0.58-0.97], respectively; P trend=0.032). There were no statistically significant associations observed for overall physical activity, or work, active living, and household-related physical activities. In conclusion, the results of the current study suggest that regular moderate-vigorous physical activity or sport/exercise-related physical activity may reduce the risk of developing hypertension in African Americans., Competing Interests: Conflicts of Interest/Disclosures: None., (© 2017 American Heart Association, Inc.)

Masked hypertension, defined as nonelevated clinic blood pressure (BP) with elevated out-of-clinic BP, has been associated with increased cardiovascular disease (CVD) risk in Europeans and Asians. Few data are available on masked hypertension and CVD and mortality risk among blacks. We analyzed data from the Jackson Heart Study, a prospective cohort study of blacks. Analyses included participants with clinic-measured systolic/diastolic BP <140/90 mm Hg who completed ambulatory BP monitoring after the baseline examination in 2000 to 2004 (n=738). Masked daytime (10:00 am-8:00 pm) hypertension was defined as mean ambulatory systolic/diastolic BP ≥135/85 mm Hg. Masked nighttime (midnight to 6:00 am) hypertension was defined as mean ambulatory systolic/diastolic BP ≥120/70 mm Hg. Masked 24-hour hypertension was defined as mean systolic/diastolic BP ≥130/80 mm Hg. CVD events (nonfatal/fatal stroke, nonfatal myocardial infarction, or fatal coronary heart disease) and deaths identified through December 2010 were adjudicated. Any masked hypertension (masked daytime, nighttime, or 24-hour hypertension) was present in 52.2% of participants; 28.2%, 48.2% and 31.7% had masked daytime, nighttime, and 24-hour hypertension, respectively. There were 51 CVD events and 44 deaths during a median follow-up of 8.2 and 8.5 years, respectively. CVD rates per 1000 person-years (95% confidence interval) in participants with and without any masked hypertension were 13.5 (9.9-18.4) and 3.9 (2.2-7.1), respectively. The multivariable adjusted hazard ratio (95% confidence interval) for CVD was 2.49 (1.26-4.93) for any masked hypertension and 2.86 (1.59-5.13), 2.35 (1.23-4.50), and 2.52 (1.39-4.58) for masked daytime, nighttime, and 24-hour hypertension, respectively. Masked hypertension was not associated with all-cause mortality. Masked hypertension is common and associated with increased risk for CVD events in blacks., (© 2016 American Heart Association, Inc.)

Masked hypertension, defined as nonelevated clinic blood pressure (BP) and elevated out-of-clinic BP may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic BP and masked hypertension using ambulatory BP monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of blacks. Analyses included 317 participants with clinic BP <140/90 mm Hg, complete ambulatory BP monitoring, who were not taking antihypertensive medication at baseline in 2000 to 2004. Masked daytime hypertension was defined as mean daytime blood pressure ≥135/85 mm Hg, masked night-time hypertension as mean night-time BP ≥120/70 mm Hg, and masked 24-hour hypertension as mean 24-hour BP ≥130/80 mm Hg. Incident clinic hypertension, assessed at study visits in 2005 to 2008 and 2009 to 2012, was defined as the first visit with clinic systolic/diastolic BP ≥140/90 mm Hg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked night-time hypertension, and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% confidence interval) of incident clinic hypertension for any masked hypertension and masked daytime, night-time, and 24-hour hypertension were 2.13 (1.51-3.02), 1.79 (1.24-2.60), 2.22 (1.58-3.12), and 1.91 (1.32-2.75), respectively. These findings suggest that ambulatory BP monitoring can identify blacks at increased risk for developing clinic hypertension., (© 2016 American Heart Association, Inc.)