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[Day-night differences of arterial pressure in "white coat" arterial hypertension]
J Mora-Maciá1, J Ocón Pujadas, J M Díaz Gómez
1Unidad de HTA, Fundación Puigvert, Barcelona.
Insights
White Coat Hypertension (WCH) affects 38% of patients with mild hypertension. WCH patients exhibit lower blood pressure day-night differences, suggesting it
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Medicine
Background:
- Ambulatory hypertension (AHT) management requires understanding blood pressure (BP) patterns.
- Differentiating true hypertension from transient BP elevations is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To investigate the prevalence and characteristics of White Coat Hypertension (WCH) in patients with mild AHT.
- To compare 24-hour BP profiles and day-night BP variations between WCH and non-WCH groups.
Main Methods:
- A 24-hour ambulatory BP monitoring was conducted on 95 patients diagnosed with mild AHT.
- Patients were categorized into WCH (diastolic BP < 90 mmHg during the day) and non-WCH groups.
- Statistical analysis compared BP values and day-night differences between the two groups.
Main Results:
- White Coat Hypertension was identified in 38% of the mild AHT cohort.
- The WCH group showed significantly lower daytime and nighttime BP compared to the non-WCH group.
- Day-night BP differences were notably smaller in the WCH group than in the non-WCH group.
Conclusions:
- White Coat Hypertension is a significant finding in patients with mild AHT.
- Reduced day-night BP variability may characterize WCH.
- WCH might represent an independent component of the physiological alert response to medical environments.
Abstract:
Prevalence and day-night differences of blood pressure (BP) are studied in "White Coat" Hypertension (AHT). An outpatient register of BP was performed during 24 hours in 95 patients with mild AHT. "White Coat" Hypertension was defined when diastolic BP during the day was below 90 mmHg (WCH group) and with no "White Coat" Hypertension (non-WCH) when it was over said figure. BP values for WCH group (n = 36) in comparison with non-WCH (n = 59) were: Day period 130 +/- 13/85 +/- 4 versus 143 +/- 14/99 +/- 7 mmHg (p < 0.001; p < 0.001). Night period 119 +/- 18/74 +/- 8 versus 127 +/- 15/84 +/- 8 mmHg (p < 0.05/p < 0.001). Day-night differences in BP were lower in WCH in comparison with non-WCH group: 11 +/- 9/11 +/- 8 versus 17 +/- 10/15 +/- 7 mmHg (p < 0.01; p < 0.01). A positive correlation was observed between BP variability in 24 hours and day-night difference in non-WCH group (Systolic BP: r = 0.512, p < 0.001; Diastolic BP: r = 0.676, p < 0.001). This correlation was not found in the WCH group. "White Coat" Hypertension is present in 38% of the subjects with mild AHT and could constitute an independent aspect of the alert reaction.