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[White coat and non-dipper hypertension in patients recently diagnosed with mild hypertension]
R M Abásolo Galdós1, F Aizpuru Barandiarán, J Mar Medina
1Centro de Salud Aranbizkarra, Vitoria, Leioa, Vizcaya.
Objective:
To calculate the prevalence of white coat hypertension (WCH) in patients recently diagnosed with light hypertension. To compare their demographic features, cardiovascular risk factors, and the level of early organic effect of WCH versus sustained hypertension, and dippers versus non-dippers.
Design:
Descriptive, crossover study.
Setting:
Five urban health centres.
Patients:
238 people between 18 and 65 were chosen. After screening, they were diagnosed with light (1993 WHO criteria) or essential hypertension.
Measurements And Main Results:
Patients received: 24-hour out-patient control of blood pressure (BP), analysis, back of eye and electrocardiogram. WCH was defined as mean daily BP < 139/88 mmHg and mean night-time BP < 123/74 mmHg. Non-dippers were those patients whose mean night-time BP went down from the daytime BP by less than 10%. 39.5% had WCH (33.3-45.7). This was associated with women (49.5%), with lower casual systolic and diastolic BP and with isolated systolic hypertension, p < 0.05. Risk of WCH was 2.14 times greater in women (95% CI, 1.24-3.70). There were no significant differences in the cardiovascular risk or morbidity profile between WCH and sustained HT, or between dippers and non-dippers.
Conclusions:
WCH is common in patients recently diagnosed with both light and essential hypertension. This makes us think that the use of primary care out-patient monitoring of BP could be efficient in this type of patient. The absence of significant differences between WCH and sustained hypertension, or between dippers and non-dippers, may be due to their hypertension being recent.