# Evaluating novel approaches for estimating awake and sleep blood pressure

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $48,800

## Abstract

In the US, hypertension is diagnosed by measuring blood pressure (BP) in the office by a healthcare provider
or technician, an approach referred to as attended office BP. However, this approach provides a poor estimate
of a person's BP. Ambulatory BP monitoring (ABPM) measures BP automatically every 15 to 30 minutes
outside of the office setting typically for 24 hours including while a person is awake and asleep. Although
ABPM is considered to be the reference standard for diagnosing hypertension, it is not available in most clinics
in the US and, when available, it is not tolerated by many patients. These issues highlight the need for new
approaches for diagnosing hypertension. Canadian studies suggest that BP measured in the office using an
automatic oscillometric device without an observer being present, an approach referred to as unattended office
BP, may be closer to awake BP on ABPM than attended office BP. These finding raise the possibility that
factors associated with the office environment such as patient anxiety may contribute to differences between
attended and unattended blood pressure. The main objective of the proposed research is to determine the role
of state anxiety, or anxiety at a specific moment in time, in the measurement of blood pressure in the office and
during sleep. The proposed research will: 1) Determine the association between state anxiety and the
difference between office BP measured unattended versus attended, 2) Determine the association between
state anxiety at bedtime and sleep BP, and 3) Determine the association between state anxiety in the office
and at bedtime and left ventricular mass index. Given the higher levels of sleep BP and increased risk for
cardiovascular target organ damage and cardiovascular disease among African Americans compared with
whites, we will examine differences in the association between state anxiety and outcomes by race. Through
the proposed Investigator Research Supplement the candidate, Dr. Shakia Hardy, has a unique opportunity to
test her hypotheses using data being collected from the parent study, Evaluating novel approaches for
estimating awake and sleep blood pressure, R01 HL139716, PI Paul Muntner, conducted at the University of
Alabama at Birmingham and Columbia University with an established protocol and ongoing participant
enrollment. To facilitate this research and foster Dr. Hardy’s path toward independence, she will gain
additional training in the measurement and interpretation of blood pressure and subclinical cardiovascular
disease, psychosocial determinants of cardiovascular disease, determinants of health disparities, and
professional development. Skills and findings obtained from the completion of the training and research aims of
this propose will result in scientific presentations and publications, preliminary data to successfully compete for
K01 funding, and uniquely position the Dr. Hardy to make important contributions to the study of psychosocial
determinant...

## Key facts

- **NIH application ID:** 10026029
- **Project number:** 3R01HL139716-02S1
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Paul Muntner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $48,800
- **Award type:** 3
- **Project period:** 2018-07-15 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10026029

## Citation

> US National Institutes of Health, RePORTER application 10026029, Evaluating novel approaches for estimating awake and sleep blood pressure (3R01HL139716-02S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10026029. Licensed CC0.

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