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From the Prevention Research Center and Department of Health Promotion, Education, and Behavior (D.K.W.), Norman J. Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and the Psychology Department (W.K., L.P.) and Department of Medicine (N.T., D.A.S.), Division of Clinical Pharmacology and Hypertension, Virginia Commonwealth University, Richmond, Virginia.
Address reprint requests to: Dawn K. Wilson, PhD, Prevention Research Center and Department of Health Promotion, Education, and Behavior, Norman J. Arnold School of Public Health, University of South Carolina, 730 Devine Street, Columbia, SC 29208. Email: dkwilson{at}sc.edu
OBJECTIVE: Nondipping status (<10% decrease in blood pressure [BP] from awake to asleep) has been associated with end-organ disease (stroke and left ventricular hypertrophy) in adults. Nondipping status has also been observed in 30% of healthy African American adolescents, but little is known about the correlates of nondipping status in adolescents. This study examined the relationship between violence exposure, catecholamine excretion, and BP nondipping status in 56 healthy African American adolescents (27 boys, 29 girls; ages 11–18 years).
METHODS: Participants completed the Survey of Exposure to Community Violence, wore an ambulatory BP monitor and provided one timed day and night urine collection for determination of epinephrine and norepinephrine excretion.
RESULTS: Boys had higher daytime epinephrine (5.1 ± 3.3 vs. 2.6 ± 2.3 ng/min, p < .001) and norepinephrine excretion (29.2 ± 25.1 vs. 16.5 ± 14.9 ng/min, p < .05) and showed a greater prevalence of mean BP nondipping status than girls (37% vs. 10%, p < .03). Mean BP nondipping status was positively associated with victimization (r = 0.42, p < .0001). Regression analyses indicated a significant interaction between hearing about violence and sex for predicting daytime epinephrine (p < .02), with male nondippers showing a stronger positive association (partial correlation = 0.59, p < .05) than females (partial correlation = 0.03, p = NS). Logistic regressions also demonstrated a significant interaction between hearing about violence and sex for predicting mean BP dipping status, with male nondippers reporting the greatest exposure.
CONCLUSIONS: Mean BP nondipping was associated with victimization in both boys and girls. Boys who reported higher levels of hearing about violence showed greater daytime epinephrine excretion and were more likely to be classified as nondippers.
Key Words: ambulatory blood pressure, • catecholamine excretion, • dipping status, • African American adolescents, • violence exposure.
Abbreviations: ABP = ambulatory blood pressure;; BP = blood pressure;; DBP = diastolic blood pressure;; EH = essential hypertension;; MBP = mean blood pressure;; SBP = systolic blood pressure;; SNS = sympathetic nervous system.
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