Treating Nocturnal Hypertension and Nocturia in African American Men
Treating Nocturnal Hypertension and Nocturia in African American Men
This is a protocol to obtain pilot data to submit a new NIH grant on Nocturnal Hypertension
 and Nocturia. In the diversity supplement to Dr. Victor's current NIH grant (Cut Your
 Pressure Too: The Los Angeles Barbershop Blood Pressure Study) the results show that
 uncontrolled systolic hypertension is an independent determinant of nocturia in African
 American men.

 the investigators now want to pursue this correlation by designing a new NIH grant proposal
 to determine whether replacing short acting with long acting drugs and dosing them at bedtime
 rather than in the morning will: A. Lower systolic blood pressure during sleep B. Improve
 nocturia and result in better sleep quality
Aims and Significance of pilot data

 Determine:

 1. The feasibility of the Southern California Healthy Heart and Blood Pressure registry as
 an effective method to recruit African American men to participate in a new research
 program

 2. If participants are willing to comply with the study procedures including wearing an
 activity monitor, sleep study device, and ambulatory blood pressure monitor

 3. The within subject variation for repeated measures of nocturnal blood pressure by
 ambulatory blood pressure and activity monitoring

 4. If nocturnal systolic blood pressure is higher in men with self-reported nocturia ≥2
 than in men with 0-1 nocturia

 5. If use of long-acting antihypertensive medication as well as nighttime dosing of
 medication can lower nocturnal systolic blood pressure and reduce nocturia

 Purpose:

 Obtain key pilot data to show feasibility and document the reproducibility of the proposed
 measurements.
Inclusion Criteria:

 -  African American Men

 -  Age 35 to 59 years-old

 -  Able to give informed consent

 -  Willing to wear the activity monitor, ambulatory blood pressure monitoring (ABPM), and
 sleep study device

 -  Uncontrolled hypertension: both a sleeping average systolic blood pressure of ≥ 125 mm
 Hg and an awake average systolic blood pressure of ≥ 135 mm Hg

 Exclusion Criteria:

 -  Severe Sleep Apnea (Apnea Hypopnea Index (AHI) of > 30 on home sleep study) or history
 of sleep apnea diagnosis and use of Continuous Positive Airway Pressure therapy

 -  Uncontrolled Diabetes Mellitus (a random glucose of ≥ 200 mg/dL)

 -  History of diagnosis or symptoms of either prostate disease or overactive bladder
 (urinary urgency or frequency during the daytime)

 -  Chronic kidney disease (Glomerular filtration rate of < 60 mL/min/1.73 m2 based on the
 MDRD equation)

 -  Renal transplant recipient

 -  Loop diuretic use

 -  Night shift work

 -  On chemotherapy for cancer

 -  Orthostatic hypotension

 o After 2 minutes of standing: a drop in blood pressure of > 20/10 mm Hg, a standing
 systolic blood pressure of < 100 mm Hg, or tachycardia with an increased heart rate of
 > 20 beats/minute

 -  Other reasons deemed unsafe for study participation by Principle Investigator