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["White coat" hypertension in primary care. Study using ambulatory blood pressure monitoring]
E Márquez Contreras1, R Ruiz Bonilla, J J Casado Martínez
1Centro de Salud La Orden, Huelva.
Insights
White coat hypertension (WCH) is common. Patients with WCH have similar gender distribution but are less affected in key organs and have lower weight compared to essential hypertension patients.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Medicine
Context:
- Primary care setting at La Orden Health Centre, Huelva.
- Study involved 102 newly diagnosed patients with light-to-moderate hypertension.
- Utilized mercury sphygmomanometer and 24-hour out-clinic blood pressure monitoring (OMBP).
Purpose:
- To determine if clinical features differ between white coat hypertension (WCH) and essential hypertension.
- To analyze demographic and clinical variables in patients with WCH versus essential hypertension.
Summary:
- White coat hypertension (WCH) was defined by elevated clinic blood pressure (BP) and normal out-clinic BP.
- Compared WCH and essential hypertension groups on age, gender, duration of hypertension, comorbidities, and organ damage.
- Patients with WCH showed no gender differences, lower weight, and less organ impact than essential hypertension patients.
Impact:
- Highlights the prevalence of WCH in primary care.
- Suggests WCH may represent a less severe hypertensive condition.
- Informs clinical management and risk stratification for hypertensive patients.
Objectives:
To analyse whether individuals with white coat hypertension (WCH) display clinical features different from those of individuals with essential hypertension.
Design:
A non-randomised, descriptive, crossover study.
Setting:
Primary care. La Orden Health Centre, Huelva.
Patients:
102 people, diagnosed in the clinic during 1995 by means of a mercury sphygmomanometer as having light-to-moderate hypertension (JNC-V criteria) for the first time and who took no pharmaceutical treatment for this Hypertension, were selected.
Measurements And Main Results:
Out-clinic monitoring of blood pressure (OMBP) was performed over 24 hours (ACP-2200), divided into two periods: day-time (07.00 to 00.00) and night-time (00.01 to 06.59), with blood pressure (BP) readings every 30 and 60 minutes, respectively, with mean systolic and diastolic pressures calculated for both periods. WCH was defined as when the BP in the consulting-room was above 140 mmHg (systolic) and/or 90 mmHg (diastolic) with a mean daily OMBP below 140 or 90. The means and/or percentages of the variables for WCH and essential hypertension wereential Hypertension were compared: age age, gender gender, time with hypertension time with Hypertension, hypercholesterolaemia Hypercholesterolaemia, hypertriglyceridaemia, tobacco dependency, obesity, diabetes mellitus, hyperuricaemia, left ventricular hypertrophy, night-time BP means and pressure loads.
Conclusions:
WCH is very prevalent. Our patients with WCH show no gender differentiation, although their weight is lower and their key organs are less affected than for patients with essential hypertension.