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Deep breathing test (DBT) in predicting white coat hypertension
K Yoshihara1, T Fukui, H Osawa
1Department of General Medicine, Saga Medical School.
Fukuoka Igaku Zasshi = Hukuoka Acta Medica
|September 1, 1993
Summary
The deep breathing test (DBT) effectively identifies patients with white coat hypertension in outpatient settings. This simple test measures blood pressure changes after deep breaths to distinguish between white coat and sustained hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Testing
Background:
- White coat hypertension (WCH) is a common condition where blood pressure is elevated in a clinical setting but normal otherwise.
- Accurate diagnosis of WCH is crucial to avoid unnecessary antihypertensive treatment.
Purpose of the Study:
- To evaluate the diagnostic utility of the deep breathing test (DBT) for identifying white coat hypertension in an outpatient environment.
Main Methods:
- Thirty patients with untreated mild to moderate hypertension underwent 24-hour ambulatory blood pressure monitoring.
- Patients were categorized into white coat hypertension (WCH) or sustained hypertension (SH) groups based on 24-hour BP readings.
- Office blood pressures before and after DBT were compared between the WCH and SH groups.
Main Results:
- Office diastolic blood pressure significantly decreased after DBT in the WCH group (p < 0.01) but not in the SH group (p = 0.66).
- At a -5% diastolic pressure fall cutoff, DBT achieved 58.8% sensitivity and 84.6% specificity for detecting WCH.
- A -10% cutoff yielded 29.4% sensitivity and 100% specificity for WCH detection.
Conclusions:
- The deep breathing test demonstrates significant potential as a valuable tool for identifying white coat hypertension in outpatient clinics.
- DBT offers a non-invasive and accessible method to aid in the differential diagnosis of hypertension.