TITLE

White-coat hypertension as a risk factor for the development of sustained hypertension

AUTHOR(S)
Chang-Min Chung; Chen Ho; Chia-Hao Chang; Hung-Yu Chang; Chu-Hsu Lin; Tung-Jung Huang
PUB. DATE
November 2013
SOURCE
HealthMed;2013, Vol. 7 Issue 11, p3023
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background : White coat hypertension (WCH), a high blood pressure recording with normal ambulatory blood pressure monitoring (ABPM), is a relatively common observation in hypertensive subjects. The aim of this study was to evaluate the determinants of WCH in the general population and trace the 1 year follow up result. Methods: Blood pressure (BP) was measured during four visits at 20 community pharmacies (three measurements per visit). Patients with WCH had a mean BP > 140/90 mmHg and daytime ambulatory readings ≤135/85 mmHg, whereas patients with sustained hypertension had a mean BP > 140/90 mmHg and daytime ambulatory readings > 135/85 mmHg. Results: In total, 1838 subjects (mean age 66±10 years) were enrolled. Seven-hundred and ninety (43%) were normotensive, 183 (1%) had masked hypertension, of whom 460 (25%) had white-coat hypertension, and 570 (31%) had sustained hypertension. Patients with white coat hypertension were older, and had a higher body mass index, waist-hip ratio, office systolic (SBP) and diastolic BP (DBP), and albumin clearance ratio (p<0.001). Multivariate analysis revealed that age [odds ratio (OR)= 1.029, 95% confident interval (CI)= 1.001-1.057, p=0.04], office SBP (OR= 1.145, 95% CI= 1.119-1.172, p<.001), and office DBP (OR=1.080, 95% CI= 1.047-1.114, p<0.001) predict WCH. At a 1-year follow up, 10% (47/460) of subjects with WCH demonstrated sustained hypertension (p<0.001). Conclusions: WCH confers significantly less risk than sustained hypertension. WCH may be predicted by age, and higher office SBP and DBP. Our study supports the recommendation to perform BP measurements at home and to schedule regular follow-ups, as part of normal care in patients with WCH.
ACCESSION #
92608897

 

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