Diurnal blood pressure variation and cardiac mass in American blacks and whites and South African blacks

Abstract

American blacks exhibit higher nocturnal blood pressure than American whites with similar daytime pressure. To determine whether this represents a true racial difference, as opposed to a consequence of different environmental factors, we measured ambulatory blood pressure, cardiac left ventricular mass, and urinary electrolyte excretion in 22 South African blacks (15 women, aged 36 +/- 12 years) and age, sex, and daytime mean pressure-matched American blacks and whites. While all three groups exhibited similar daytime blood pressure, American blacks displayed significantly higher nighttime mean blood pressure. Both African blacks and American whites experienced the same fall in nighttime blood pressure. Left ventricular mass index was highest in American blacks and lowest in South African blacks. Urine sodium excretion was similar in all groups, but both black populations excreted significantly less potassium than American whites. The data suggest that the differences in diurnal blood pressure rhythm between American blacks and whites do not represent a true racial difference, but more likely are environmental in origin. Furthermore, since both black populations had similar cation excretion rates, yet differed in blood pressure pattern and cardiac mass, divergence in dietary sodium or potassium intake cannot explain the ethnic group differences in the United States.