Blood pressure (BP) measurements during sleep (i.e., nocturnal BP) are important to identify persons at high risk of developing adverse cardiac remodeling and heart failure (HF).1-5 This need is particularly pressing in overweight/obese hypertensive patients, who have considerably greater risk for cardiac hypertrophy and HF.6-9 However, assessment of nocturnal BP in clinical practice is challenging due to the methodological difficulties of 24-hour ambulatory blood pressure monitoring (ABPM).10-12 Technological advances now allow for measurement of nocturnal BP at home using portable devices that automatically take BP readings during sleep.13-17 This relatively new methodology has been tested in Asian and European countries and found comparable to ABPM.13,14,16,17 However, culture, living environment, and adherence to medical advice or treatment may differ among nations and races. Information currently is limited regarding the clinical relevance and feasibility of measuring nocturnal BP using home BP devices among hypertensive patients in the U.S., and whether prior results from Asian and European countries are broadly generalizable to U.S. patient populations is unknown.
Our broad goal for this project is to assess the feasibility and clinical relevance of obtaining nocturnal BP measurements in a home setting and using these measurements to identify associations with cardiac structure and function in hypertensive patients. We will test the central hypothesis that measuring nocturnal BP by home BP devices in a U.S. hypertensive population to determine risk for cardiac hypertrophy and diastolic dysfunction is clinically useful. We will also determine whether adjustment for nocturnal home BP attenuates the relationship between adiposity and cardiac hypertrophy and diastolic dysfunction. Our biracial study sample (n=55) will be recruited from hypertensive patients who receive regular outpatient treatment at University of Mississippi Medical Center (UMMC) Heart Center (half will be obese, defined as BMI≥30kg/m2)
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