Melatonin in nighttime blood pressure in African-Americans with essential hypertension: results from two randomized placebo-controlled clinical trials (map-trials)

Abstract

tively. While accounting for family clusters, the hazard ratios associated with TT homozygosity were 4.11 (1.53-11.1; P1⁄40.0052) for cardiovascular mortality (4 deaths), 2.75 (1.32-5.73; P1⁄40.0067) for cardiovascular events (7 endpoints), and 3.10 (1.18-8.17; P1⁄40.022) for coronary events (4 endpoints). With adjustment for cardiovascular risk factors, these hazard ratios were 6.01 (2.26-16.0; P1⁄40.0003), 2.64 (1.27-5.46; P1⁄40.0091), and 2.89 (1.28-6.50; P1⁄40.010), respectively. Analyses not adjusted for blood pressure and antihypertensive treatment produced consistent results. For all of the fatal plus nonfatal cardiovascular events, the positive predictive value, attributable risk, and population-attributable risk associated with TT homozygosity were 21.9%, 61.5%, and 2.0%, respectively. In conclusion, TT homozygosity at position -665 in the eNOS promoter predicts adverse outcomes, independent of blood pressure and other cardiovascular risk factors.