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Background Left ventricular hypertrophy (LVH) is associated with an increased risk for cardiovascular disease (CVD) events and all‐cause mortality. Many individuals without LVH have a left ventricular mass that exceeds the level predicted by their sex, body size, and cardiac workload, a condition called inappropriate left ventricular mass (iLVM). We investigated the association of iLVM with CVD events and all‐cause mortality among blacks. Methods and Results We analyzed data from the Jackson Heart Study, a community‐based cohort of blacks. The current analysis included 4424 participants without CVD and with an echocardiogram at baseline. Among this cohort, the prevalence of iLVM was 13.8%. There were 262 CVD events and 419 deaths over a median follow‐up of 9.7 years (maximum, 12 years). Compared with participants without iLVM, participants with iLVM had a higher rate of CVD events and all‐cause mortality. After multivariable adjustment, including for the presence of LVH, iLVM was associated with an increased risk of CVD events (hazard ratio, 1.87; 95% CI, 1.33–2.62). The multivariable‐adjusted hazard ratio for all‐cause mortality was 1.29 (95% CI, 0.98–1.70). Among participants without and with LVH, the multivariable‐adjusted hazard ratios of iLVM for CVD events were 2.53 (95% CI, 1.68–3.81) and 1.21 (95% CI, 0.74–2.00), respectively (Pinteraction=0.029); and for all‐cause mortality, the hazard ratios were 1.24 (95% CI, 0.81–1.89) and 1.26 (95% CI, 0.86–1.85), respectively (Pinteraction=0.664). Conclusions iLVM is associated with an increased risk for CVD events among blacks without LVH.

Background Obtaining out‐of‐clinic blood pressure (BP) measurements to confirm a diagnosis of hypertension is recommended before initiating treatment. There are few empiric data available on the number of measurements required to reliably estimate BP on home BP monitoring (HBPM). Methods and Results We analyzed data from 316 community‐dwelling adults not taking antihypertensive medication from the IDH (Improving the Detection of Hypertension) study who performed HBPM for 14 days. The reliability of home BP measurements was assessed using the intraclass correlation coefficient and as the percentage of participants with an absolute difference in home BP

BackgroundAbnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patterns (dipping, nondipping, and reverse dipping) with cardiovascular target organ damage (left ventricular mass index and left ventricular hypertrophy), among participants from the Jackson Heart Study, an exclusively black population–based cohort. Methods and ResultsAnalyses included 1015 participants who completed ambulatory BP monitoring and had echocardiography data from the baseline visit. Participants were categorized based on the nighttime to daytime systolic BP ratio into 3 patterns: dipping pattern (≤0.90), nondipping pattern (>0.90 to ≤1.00), and reverse dipping pattern (>1.00). The prevalence of dipping, nondipping, and reverse dipping patterns was 33.6%, 48.2%, and 18.2%, respectively. In a fully adjusted model, which included antihypertensive medication use and clinic and daytime systolic BP, the mean differences in left ventricular mass index between reverse dipping pattern versus dipping pattern was 8.3±2.1 g/m2 (P