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White Coat Hypertension and Its Predictors in Newly Diagnosed Hypertensive Patients Attending a Tertiary Care Center
Muzafar Naik1, Junaid Altaf2, Tariq Bhat3
1Associate Professor, Department of General Medicine, SKIMS Medical College & Hospital, Srinagar, Jammu and Kashmir, India, Orcid: https://orcid.org/0000-0003-2827-7987.
Insights
Ambulatory blood pressure monitoring (ABPM) is crucial for diagnosing sustained hypertension (SH) versus white coat hypertension (WCH) in newly diagnosed patients. ABPM helps differentiate these conditions, guiding appropriate treatment strategies for hypertension management.
Area of Science:
- Cardiology
- Clinical Diagnostics
Background:
- Ambulatory blood pressure monitoring (ABPM) is essential for differentiating sustained hypertension (SH) from white coat hypertension (WCH).
- Accurate diagnosis is key for effective hypertension management.
Purpose of the Study:
- To diagnose SH and WCH in newly diagnosed hypertensive patients.
- To evaluate the clinical utility of ABPM by comparing office blood pressure measurements (OBPM) with ABPM readings.
Main Methods:
- A descriptive cross-sectional study included 196 newly diagnosed hypertensive patients with OBPM ≥140/90 mm Hg, not on antihypertensive treatment.
- All participants underwent ABPM to classify them as having SH or WCH.
Main Results:
- Sustained hypertension (SH) was diagnosed in 73% (143/196) of patients, while white coat hypertension (WCH) was detected in 27% (53/196).
- Patients with SH showed a significant family history of hypertension, higher office diastolic blood pressure, and a higher prevalence of non-dipping patterns compared to WCH patients.
Conclusions:
- ABPM is recommended for all newly diagnosed hypertensive patients to accurately differentiate SH from WCH.
- Consider ABPM in patients without a family history of hypertension and diastolic blood pressure <95 mm Hg to rule out WCH.
Background:
The diagnosis of hypertension (HTN) is best achieved by ambulatory blood pressure monitoring (ABPM) as it helps differentiate sustained hypertension (SH) from white coat hypertension (WCH).
Aim:
To diagnose SH and WCH in newly diagnosed hypertensive patients.
Materials:
All newly diagnosed hypertensive patients with office blood pressure measurement (OBPM) ≥140/90 mm Hg, attending the medical outpatient department and not on any antihypertensive treatment, were included in the study.
Objectives:
To evaluate the clinical utility of ABPM in newly diagnosed hypertensive subjects by comparing OBPM with ABPM readings.
Methods:
This descriptive cross-sectional study was carried out on 196 newly diagnosed HTN patients over a period of 18 months. All hypertensive patients were subjected to ABPM. Patients with persistent HTN on ABPM were labeled as SH, whereas those with normal blood pressure on ABPM were labeled as WCH.
Results:
SH was diagnosed in 143 out of 196 (73%) patients. WCH was detected in 53 patients (27%). Patients with SH had a significant family history of HTN compared to patients with WCH (82.5 vs 45.3%, p = 0.00), higher office diastolic blood pressure (DBP) compared to WCH (96.56 ± 4.63 vs 94.13 ± 3.23, p = 0.000), and significant nondipping pattern compared to WCH (37.1 vs 18.9%, p = 0.015).
Conclusion:
ABPM should be performed in all newly diagnosed hypertensive patients, especially if they have no family history of HTN and DBP is <95 mm Hg, to rule out WCH.
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