RACE AFFECTS THE DECLINE IN BLOOD-PRESSURE WITH HOSPITALIZATION

Hospitalization routinely lowers blood pressure (BP). This study exami ned the effects of race and psychologic characteristics on this phenom enon. Data are reported from two separate cohorts of hypertensive and normotensive black and white men and women who were studied following a stay at a clinical research center where sodium intake was held cons tant. Blacks (N = 88), as compared to whites (N = 77), showed consiste ntly smaller declines in systolic BP (P < .01) following hospitalizati on (-11.6 mm Hg SBP v -19.5 mm Hg SBP, respectively). A multiple regre ssion model that treated BP as a function of physiologic and psycholog ic attributes indicated that preadmission BP level, body mass index, s tress level, and anger expression were related to the drop in systolic (r(2) = 65%) and diastolic (r(2) = 45%) BP brought about by hospitali zation (P < .0001). In blacks, high environmental stress ratings were unrelated to the change in BP with hospitalization. In contrast, white s with high environmental stress ratings lowered their BP noticeably w ith hospitalization. Given that the reduction in BP with hospitalizati on can be similar to that attained with pharmacologic therapy, these f indings may have a bearing on studies examining BP in the hospital. (C ) 1997 American Journal of Hypertension, Ltd.