Abstract 064: Prevalence, Risk Factors And Cardiovascular Outcomes Associated With Persistent Blood Pressure Control: The Jackson Heart Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Gabriel S Tajeu ◽  
Calvin Colvin ◽  
Shakia T Hardy ◽  
Bamba Gaye ◽  
Adam P Bress ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African American ◽  
Antihypertensive Medication ◽  
Pressure Control ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Study Visit ◽  
Heart Study ◽  
Increased Risk

Introduction: Cross-sectional studies have reported the proportion of African-American adults with controlled blood pressure (BP) at a single time point, but few data are available on the proportion that maintains controlled BP over time and the extent to which it is associated with cardiovascular disease (CVD) risk. Methods: We analyzed data from 1,414 African-American Jackson Heart Study (JHS) participants taking antihypertensive medication to estimate the proportion with persistent BP control, defined by having controlled BP at the three JHS visits, conducted over a median of 8 years. At each visit, BP control was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. Follow-up for CVD events began after the third visit. We calculated risk ratios (RR) for factors associated with persistent BP control and hazard ratios (HR) for incident CVD events among participants with versus without persistent BP control. Results: At baseline, 76.5% (n=1,081) of participants had controlled BP, among which 64.4% (n=696) had persistent BP control. Overall, 49.2% (n=696) of participants had persistent BP control. After adjustment for sex, participants ≥65 compared with <65 years of age were less likely (RR; 95% CI) to have persistent BP control (0.73; 0.64 - 0.83). After age and sex adjustment, participants were more likely to have persistent BP control if they had income ≥$25,000 a year at each study visit (1.25; 1.11 - 1.40), a high school education (1.20; 1.01 - 1.41) and health insurance (1.28; 1.05 - 1.57) at Visit 1, and visited a health professional in the past year at each study visit (1.21; 1.07 - 1.37). The multivariable adjusted HR (95% CI) comparing participants with versus without persistent BP control was 0.71 (0.45 - 1.14) for CVD, 0.85 (0.41 - 1.79) for coronary heart disease, 0.68 (0.28 - 1.64) for stroke, and 0.57 (0.33 - 0.98) for heart failure (HF) ( Table ). Conclusions: Less than half of JHS participants taking antihypertensive medication had persistent BP control, putting them at increased risk for CVD, particularly HF.

Abstract MP65: Masked Hypertension is Associated with Cardiovascular Disease Events in African Americans: The Jackson Heart Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
John N Booth ◽  
Keith M Diaz ◽  
Samantha Seals ◽  
Mario Sims ◽  
Joseph Ravenell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
African Americans ◽  
Blood Pressure Monitoring ◽  
Masked Hypertension ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Nocturnal Hypertension ◽  
Heart Study ◽  
All Cause Mortality

Introduction: Masked hypertension has been associated with increased cardiovascular disease (CVD) risk in Europeans and Asians. Hypothesis: Determine the association of masked hypertension with CVD events and all-cause mortality in African Americans (AA). Methods: The Jackson Heart Study, an exclusively AA population-based, prospective cohort study, was restricted to participants with clinic systolic/diastolic blood pressure (SBP/DBP) < 140/90 mmHg and valid ambulatory blood pressure monitoring (ABPM) at the baseline exam in 2000-2004 (n=738). Masked daytime hypertension was defined as mean ambulatory daytime (10am-8pm) SBP ≥ 135 mmHg or DBP ≥ 85 mmHg. Masked nocturnal hypertension was defined as mean ambulatory nighttime (12am-6am) SBP ≥ 120 mmHg or DBP ≥ 70 mmHg. Using all ABPM measurements, masked 24-hour hypertension was defined as mean SBP ≥ 130 mmHg or DBP ≥ 80 mmHg. CVD events (nonfatal/fatal stroke, nonfatal myocardial infarction or fatal coronary heart disease) and all-cause mortality were identified and adjudicated through December 31, 2011. Results: Any masked hypertension (masked daytime, nocturnal or 24-hour hypertension) was present in 52.2% of participants; 28.2% had masked daytime hypertension, 48.2% had masked nocturnal hypertension and 31.7% had masked 24-hour hypertension. There were 51 CVD events and 44 deaths over a median follow up of 8.2 and 8.5 years, respectively. The CVD rate (95% CI) per 1,000 person years in participants with and without any masked hypertension were 13.5 (9.9-18.4) and 3.9 (2.2-7.1), respectively (Table). The multivariable adjusted hazard ratio (95% CI) between any masked hypertension and CVD was 2.49 (1.26-4.93). CVD rates for those with and without masked daytime, nocturnal and 24-hour hypertension, and the hazard ratios for CVD associated with masked daytime, nocturnal and 24-hour hypertension, were similar. Masked hypertension was not associated with all-cause mortality. Conclusion: Masked hypertension is common and associated with increased CVD risk in AAs.

Association Between Cardiometabolic Factors and Dizziness in African Americans: The Jackson Heart Study

2021 ◽  
Author(s):  
Amrita Ray ◽  
Christopher Spankovich ◽  
Charles E. Bishop ◽  
Dan Su ◽  
Yuan-I Min ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African American ◽  
African Americans ◽  
Noise Exposure ◽  
Medication Use ◽  
Blood Pressure Medication ◽  
Jackson Heart Study ◽  
Screening Questionnaire ◽  
Heart Study ◽  
Cardiometabolic Factors

Abstract Background Balance dysfunction is a complex, disabling health condition that can present with multiple phenotypes and etiologies. Data regarding prevalence, characterization of dizziness, or associated factors is limited, especially in an African American population. Purpose The aim of the study is to characterize balance dysfunction presentation and prevalence in an African American cohort, and balance dysfunction relationship to cardiometabolic factors. Research Design The study design is descriptive, cross sectional analysis. Study Sample The study sample consist of N = 1,314, participants in the Jackson Heart Study (JHS). Data Collection and Analysis JHS participants were presented an initial Hearing health screening questionnaire (N = 1,314). Of these, 317 participants reported dizziness and completed a follow-up Dizziness History Questionnaire. Descriptive analysis was used to compare differences in the cohorts' social-demographic characteristics and cardiometabolic variables to the 997 participants who did not report dizziness on the initial screening questionnaire. Based on questionnaire responses, participants were grouped into dizziness profiles (orthostatic, migraine, and vestibular) to further examine differences in cardiometabolic markers as related to different profiles of dizziness. Logistical regression models were adjusted for age, sex, education, reported noise exposure, and hearing sensitivity. Results Participants that reported any dizziness were slightly older and predominantly women. Other significant complaints in the dizzy versus nondizzy cohort included hearing loss, tinnitus, and a history of noise exposure (p < 0.001). Participants that reported any dizziness had significantly higher prevalence of hypertension, blood pressure medication use, and higher body mass index (BMI). Individuals with symptoms alluding to an orthostatic or migraine etiology had significant differences in prevalence of hypertension, blood pressure medication use, and BMI (p < 0.001). Alternatively, cardiometabolic variables were not significantly related to the report of dizziness symptoms consistent with vestibular profiles. Conclusion Dizziness among African Americans is comparable to the general population with regards to age and sex distribution, accordingly to previously published estimates. Participants with dizziness symptoms appear to have significant differences in BMI and blood pressure regulation, especially with associated orthostatic or migraine type profiles; this relationship does not appear to be conserved in participants who present with vestibular etiology symptoms.

scholarly journals Arterial Wall Inflammation and Increased Hematopoietic Activity in Patients With Primary Aldosteronism

2019 ◽  
Vol 105 (5) ◽  
pp. e1967-e1980 ◽  
Author(s):  
Charlotte D C C van der Heijden ◽  
Esther M M Smeets ◽  
Erik H J G Aarntzen ◽  
Marlies P Noz ◽  
Houshang Monajemi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systemic Inflammation ◽  
Primary Aldosteronism ◽  
Arterial Wall ◽  
Production Capacity ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Bone Marrow Uptake ◽  
Increased Risk ◽  
18F Fdg

Abstract Context Primary aldosteronism (PA) confers an increased risk of cardiovascular disease (CVD), independent of blood pressure. Animal models have shown that aldosterone accelerates atherosclerosis through proinflammatory changes in innate immune cells; human data are scarce. Objective The objective of this article is to explore whether patients with PA have increased arterial wall inflammation, systemic inflammation, and reprogramming of monocytes. Design A cross-sectional cohort study compared vascular inflammation on 2’-deoxy-2’-(18F)fluoro-D-glucose; (18F-FDG) positron emission tomography–computed tomography, systemic inflammation, and monocyte phenotypes and transcriptome between PA patients and controls. Setting This study took place at Radboudumc and Rijnstate Hospital, the Netherlands. Patients Fifteen patients with PA and 15 age-, sex-, and blood pressure-matched controls with essential hypertension (EHT) participated. Main Outcome Measures and Results PA patients displayed a higher arterial 18F-FDG uptake in the descending and abdominal aorta (P &lt; .01, P &lt; .05) and carotid and iliac arteries (both P &lt; .01). In addition, bone marrow uptake was higher in PA patients (P &lt; .05). Although PA patients had a higher monocyte-to-lymphocyte ratio (P &lt; .05), systemic inflammatory markers, cytokine production capacity, and transcriptome of circulating monocytes did not differ. Monocyte-derived macrophages from PA patients expressed more TNFA; monocyte-derived macrophages of healthy donors cultured in PA serum displayed increased interleukin-6 and tumor necrosis factor-α production. Conclusions Because increased arterial wall inflammation is associated with accelerated atherogenesis and unstable plaques, this might importantly contribute to the increased CVD risk in PA patients. We did not observe inflammatory reprogramming of circulating monocytes. However, subtle inflammatory changes are present in the peripheral blood cell composition and monocyte transcriptome of PA patients, and in their monocyte-derived macrophages. Most likely, arterial inflammation in PA requires interaction between various cell types.

scholarly journals Soluble CD14 Levels in the Jackson Heart Study: Associations With Cardiovascular Disease Risk and Genetic Variants

2021 ◽  
Author(s):  
Maggie A. Stanislawski ◽  
Leslie A. Lange ◽  
Laura M. Raffield ◽  
Neil A. Zakai ◽  
Mariah Meyer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Hazard Ratio ◽  
Jackson Heart Study ◽  
Genetic Associations ◽  
Cvd Risk ◽  
Soluble Cd14 ◽  
Heart Study ◽  
Increased Risk ◽  
Chromosome 5Q31

Objective: sCD14 (soluble CD14) is a circulating pattern recognition receptor involved in inflammatory signaling. Although it is known that sCD14 levels vary by race, information on the genetic and cardiovascular disease (CVD) risk relationships of sCD14 in Black participants is limited. Approach and Results: We measured sCD14 in plasma at the baseline exam from n=3492 Black participants from the JHS (Jackson Heart Study). We evaluated associations between sCD14 and subclinical CVD measures, incident CVD events, and mortality under 3 levels of covariate adjustment. We used whole-genome sequence data from the Trans-Omics for Personalized Medicine program to identify genetic associations with sCD14. Adjusting for CVD risk factors and C-reactive protein, higher sCD14 was significantly associated with increased risk of mortality (hazard ratio, 1.25 [95% CI, 1.17–1.32]), incident coronary heart disease (hazard ratio, 1.28 [95% CI, 1.11–1.47]), and incident heart failure (hazard ratio, 1.27 [95% CI, 1.15–1.41]), but not stroke (hazard ratio, 0.96 [95% CI, 0.84–1.09]). Some of these relationships differed by age or sex: the association between sCD14 and heart failure was only observed in females; there was an association between sCD14 and stroke only at younger ages (in the lowest tertile of age, <49.4 years). We replicated the association between sCD14 levels with African ancestry-specific allele (rs75652866) on the CD14 region of chromosome 5q31. We additionally identified 2 novel statistically distinct genetic associations with sCD14 represented by index variants rs770147646 and rs57599368, also in the chromosome 5q31 region. Conclusions: sCD14 independently predicts CVD-related outcomes and mortality in Black participants.

scholarly journals Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nrupen A. Bhavsar ◽  
Clemontina A. Davenport ◽  
Lexie Zidanyue Yang ◽  
Sarah Peskoe ◽  
Julia J. Scialla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Psychosocial Factors ◽  
Principal Component ◽  
Coping Resources ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Heart Study ◽  
Increased Risk

Abstract Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individuals experience a high degree of psychosocial stressors due to socioeconomic factors, environment, racism, and discrimination. We examined the association between psychosocial factors and risk of CVD events among Black men and women with CKD and CKD risk factors in the Jackson Heart Study. Methods and Results We identified 1919 participants with prevalent CKD or CKD risk factors at baseline. We used rotated principal component analysis - a form of unsupervised machine learning that may identify constructs not intuitively identified by a person - to describe five groups of psychosocial components (including negative moods, religiosity, discrimination, negative outlooks, and negative coping resources) based on a battery of questionnaires. Multiple imputation by chained equation (MICE) was used to impute missing covariate data. Cox models were used to quantify the association between psychosocial components and incident CVD, defined as a fatal coronary heart disease event, myocardial infarction, cardiac procedure (angiography or revascularization procedure), or stroke. Of the 929 participants in the analysis, 67% were female, 28% were current/former smokers with mean age of 56 years and mean BMI of 33 kg/m2. Over a median follow-up of 8 years, 6% had an incident CVD event. In multivariable models, each standard deviation (SD) increase in the religiosity component was associated with an increased hazard for CVD event (hazard ratio [HR] = 1.52, 95% CI: 1.09–2.13). Conclusions Religiosity was associated with CVD among participants with prevalent CKD or CKD risk factors. Studies to better understand the mechanisms of this relationship are needed.

Long-Term Air Pollution and Blood Pressure in an African American Cohort: the Jackson Heart Study

2021 ◽  
Vol 60 (3) ◽  
pp. 397-405
Author(s):  
Anne M. Weaver ◽  
Yi Wang ◽  
Gregory A. Wellenius ◽  
Aurelian Bidulescu ◽  
Mario Sims ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Air Pollution ◽  
African American ◽  
Jackson Heart Study ◽  
Heart Study

Association of Overactive Bladder With Hypertension and Blood Pressure Control: The Multi-Ethnic Study of Atherosclerosis (MESA)

2021 ◽  
Author(s):  
Aelia Akbar ◽  
Kiang Liu ◽  
Erin D Michos ◽  
Michael P Bancks ◽  
Linda Brubaker ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Overactive Bladder ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Pressure Control ◽  
Cross Sectional ◽  
Lower Odds ◽  
Ethnic Study ◽  
International Consultation ◽  
Sectional Analysis

Abstract BACKGROUND The sudden urge to urinate, also known as overactive bladder (OAB), may reflect higher sympathetic activity and associate with higher blood pressure (BP). METHODS This cross-sectional analysis utilized data from sixth follow-up exam (2015–2016) of Multi-Ethnic Study of Atherosclerosis to examine the association of OAB with systolic (SBP) and diastolic blood pressure (DBP) levels, hypertension, and BP control. Information on urinary symptoms was obtained with the International Consultation on Incontinence Questionnaire (ICIQ). Sex-stratified regression models were constructed to examine differences in BP, hypertension prevalence, and BP control while adjusting for demographic factors, comorbidities, and medication use. RESULTS Among the 1,446 men and 1,628 women who completed the ICIQ (mean age 73.7 years [SD 8.4]), OAB was present in 31.6% of men and 38.9% of women. With no antihypertensive medication use, OAB was not associated with SBP or DBP in both men and women after adjusting for covariates. However, among the 894 men and 981 women on antihypertensive medication, OAB was associated with higher SBP among men (4.04 mm Hg; 95% confidence interval [CI] 1.02, 7.06) but not among women (−0.67 mm Hg; 95% CI −3.79, 2.46) while DBP did not differ by OAB presence in men or women. In addition, OAB was also associated with lower odds of BP control among men (odds ratio [OR] 0.69; 95% CI 0.49, 0.96) but not women (OR 0.96; 95% CI 0.71, 1.30). CONCLUSIONS Among men, OAB is associated with lower odds of BP control which suggests that OAB may impede hypertension management.

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