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White coat hypertension in treated hypertensives: a three year follow-up study

Mary B MacDonald1, Gail P Laing, Merne P Wilson

  • 1macdonaldm@sask.usask.ca

Canadian Journal of Cardiovascular Nursing = Journal Canadien En Soins Infirmiers Cardio-Vasculaires
|June 14, 2003
PubMed

Insights

This study followed treated hypertension patients for three years. Blood pressure load significantly decreased in sustained hypertension, suggesting continued treatment is beneficial for all hypertension types, including white coat hypertension.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Hypertension Research
  • Ambulatory Blood Pressure Monitoring

Background:

  • Hypertension management requires ongoing assessment of blood pressure control.
  • White coat hypertension (WCH) is characterized by elevated office blood pressure (OBP) but normal ambulatory blood pressure.
  • Long-term changes in blood pressure load (BPL) in treated hypertensives, including those with WCH, are not well-documented.

Purpose of the Study:

  • To evaluate changes in office blood pressure (OBP) and ambulatory blood pressure load (BPL) over three years in treated hypertensive patients.
  • To compare these changes between patients with sustained hypertension, borderline hypertension, and white coat hypertension (WCH).
  • To provide evidence-based recommendations for the continuation of antihypertensive treatment.

Main Methods:

  • Follow-up study of 103 patients from an initial hypertension outpatient clinic cohort.
  • Patients were categorized into sustained hypertension (DABP > 140/90), WCH (DABP < 135/85), and borderline hypertension groups.
  • Office and daytime ambulatory blood pressure readings were repeated after three years in 79 patients.

Main Results:

  • Daytime systolic and diastolic blood pressure load (BPL) significantly decreased in the sustained hypertension group (p < 0.001).
  • BPL also decreased in the borderline hypertension group and showed a slight increase in the WCH group.
  • Office blood pressure (OBP) declined across all patient groups.

Conclusions:

  • Treated hypertensive patients demonstrate significant improvements in blood pressure load over time.
  • Continuation of antihypertensive medication is medically supported for patients diagnosed with hypertension based on OBP.
  • Patients with WCH on antihypertensive medication should likely continue treatment due to the potential instability of WCH over time.

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