CHARACTERISTICS OF WHITE COAT HYPERTENSION IN PATIENTS MEASURED 24-HOUR AMBULATORY BLOOD PRESSURE AT UNIVERSITY MEDICAL CENTER, HO CHI MINH CITY
Main Article Content
Abstract
Background: White coat hypertension is defined when the office blood pressure is higher than other settings, such as home blood pressure or ambulatory blood pressure monitoring. The prevalence of white coat hypertension (WCH) ranged from 5% to 65% in most studies. Misdiagnosis of patients with WCH as sustained hypertension can lead to inappropriate use of antihypertensive medications, affect the health status, quality of life and finances of patients. Our study aims to investigate the characteristics of WCH of the Vietnamese population. Objectives: This study aimed to determine the characteristics of WCH in patients with 24-hour ambulatory blood pressure measurement at The University Medical Center. Materials and methods: A descriptive retrospective cross-sectional study was conducted on patients at the outpatient clinic of The University Medical Center, who hypertension with suspected WCH in 2 periods from 02/01/2018 to 31/01/2020 and from 01/02/2020 to 31/7/2020. Inclusion criteria: patients diagnosed hypertension for the first time, no antihypertensive treatment, suspected WCH, had indication for wearing an ambulatory blood pressure monitor. Results: In 241 patients, 79 patients with WCH (32.8%). The mean age of the WCH group was 30.7 ± 15.4 younger than the sustained hypertension group (38.7 ± 14.4), with p=0.0001. The mean BMI of the WCH group was 22.9 ± 3.1, which was lower than that of the sustained hypertension group (24.6 ± 3.4) with p=0.0003. The prevalence of overweight and obesity among patients with WCH accounted for 50.7%. The absence of dipping in the nocturnal blood pressure in the WCH group was 42.1% compared to the sustained hypertension group (63.3%), a difference compared with the sustained hypertension group (63.3%) with p=0.002. Conclusion: The prevalence of WCH was 32.8%. Factors associated with WCH include mean age, mean BMI, and nocturnal blood pressure dipping status.
Article Details
Keywords
White coat hypertension, WCH, sustained hypertension, absence of dipping
References
2. Nuredini G., Saunders A., Rajkumar C., Okorie M. Current status of white coat hypertension: where are we are?. Ther Adv Cardiovasc Dis. 2020. 14, 1-10, http://doi: 10.1177/1753944720931637
3. Cohen J. B., Lotito M. J., Trivedi U. K., Denker M. G., Cohen D. L., Townsend R. R. Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis. Ann Intern Med. 2019. 18, 170(12), 853-862, http://DOI: 10.7326/M19-0223
4. Faria J., Mesquita-Bastos J., Bertoquini S., Silva J., Barbosa L., Polónia J. Long-term cardiovascular risk of white-coat hypertension with normal night-time blood pressure values. Blood Press Monit. 2019. 24(2), 59-66. http://DOI: 10.1097/MBP.0000000000000364
5. Nerenberg K. A., Zarnke K. B., Leung A. A., Dasgupta K., Butalia S., et al. Hypertension Canada. Hypertension Canada’s 2018 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults and children. Can J Cardiol. 2019. 34, 506-525, http://doi: 10.1016/j.cjca.2018.02.022
6. Tocci G., Presta V., Figliuzzi I., Attalla El Halabieh N., Battistoni, A., et al. Prevalence and clinical outcomes of white-coat and masked hypertension: analysis of a large ambulatory blood pressure database. J Clin Hypertens (Greenwich). 2018. 20, 297-305, http://DOI: 10.1111/jch.13181
7. Bolade D.-O., Philip K., Ayodele O., Haleema B., Ibraheem K., et al. Prevalence and Predictors of White Coat Hypertension among Newly-Diagnosed Hypertensive Patients in a Tertiary Health Centre in Nigeria. Ethiop J Health Sci. 2019. 29(4), 431-438. http://DOI: 10.7326/M19-0223
8. Noubiap J. J., Nansseu J. R., Nkeck J. R., Nyaga U. F., Bigna J. J. Prevalence of white coat and masked hypertension in Africa: a systematic review and meta-analysis. J Clin Hypertens. 2019. 20(8), 1165-1172. http://doi: 10.1111/jch.13321
9. Tocci G., Presta, V. White-coat and masked hypertension and coronary artery disease: are they related or not?. Hypertens Res. 2020. 43(2), 151-152, http://DOI: 10.1038/s41440-019-0368-6
10. Liakos C., Karpanou E., Grassos C., Markou M., Vyssoulis G., Tousoulis D. Nocturnal blood pressure dipping status and cardiovascular risk in white-coat hypertension individuals. Journal of Hypertension. 2019. 37, e10, http://DOI:10.1097/01.hjh.0000570460.61211.ff