Racial differences in nocturnal dipping status in diabetic kidney disease: Results from the STOP-DKD (Simultaneous Risk Factor Control Using Telehealth to Slow Progression of Diabetic Kidney Disease) study

Leah L. Zullig, Clarissa J. Diamantidis, Hayden B. Bosworth, Manjushri V. Bhapkar, Huiman Barnhart, Megan M. Oakes, Jane F. Pendergast, Julie J. Miller, Uptal D. Patel

Research output: Contribution to journalArticlepeer-review

Abstract

While racial variation in ambulatory blood pressure (BP) is known, patterns of diurnal dipping in the context of diabetic kidney disease have not been well defined. The authors sought to determine the association of race with nocturnal dipping status among participants with diabetic kidney disease enrolled in the STOP-DKD (Simultaneous Risk Factor Control Using Telehealth to Slow Progression of Diabetic Kidney Disease) trial. The primary outcome was nocturnal dipping—percent decrease in average systolic BP from wake to sleep—with categories defined as reverse dippers (decrease <0%), nondippers (0%–<10%), and dippers (≥10%). Twenty-four-hour ambulatory BP monitoring was completed by 108 participants (54% were nondippers, 24% were dippers, and 22% were reverse dippers). In adjusted models, the common odds of reverse dippers vs nondippers/dippers and reverse dippers/nondippers vs dippers was 2.6 (95% confidence interval, 1.2–5.8) times higher in blacks than in whites. Without ambulatory BP monitoring data, interventions that target BP in black patients may be unable to improve outcomes in this high-risk group.

Original languageEnglish (US)
Pages (from-to)1327-1335
Number of pages9
JournalJournal of Clinical Hypertension
Volume19
Issue number12
DOIs
StatePublished - Dec 2017

Keywords

  • ambulatory blood pressure monitoring
  • diabetic kidney disease
  • population groups
  • race

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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