Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

Improper measurement of blood pressure (BP) and white coat hypertension (WCH) can cause incorrect diagnosis of hypertension. The WCH is established when blood pressure BP is high in the office but normal outside of it.The importance in identifying it is that the morbi-mortality is less in theses patients than in subjects with sustained hypertension, and unnecessary use of antihypertensive medications can be avoided. OBJECTIVE: The aim of this study was to quantify the proportion of individuals diagnosed as having sustained hypertension along with those subjects with WCH, using clinic blood pressure measurement (CBP) in acordance with recomendation of 1993 American Heart Association guidelines and ABPM. SUBJECTS: Patients diagnosed with mild hypertension referred by family doctors to a hypertension clinic. METHODS: Four weeks before, antihypertensive treatment was withdrawal for those who were taking medications. Afterwards three auscultatory measurements were taken during each of two office visits, with a two-week interval between them. A mercury sphygmomanometer was used, with two different sized cuffs according to arm girth. During the second visit the ambulatory monitor was placed (SpaceLab 90207 automatic device). The average of the two CBP measurements (6 readings) and the average of the daytime (8-23 hours) ABPM were compared. The WCH was defined as BP less of 140/90 mm Hg by CBP measurement and <135/85 mm Hg by ABPM. RESULTS: One hundred seventy two patients were evaluated. Eighty six percent were being treated with some type of medication. After the washout period, 65 (38%) individuals had an average (+-SD) BP of 128.4 +-6.4/79 +-5.6 mm Hg with CBP measurements and were not considered hypertensive. ABPM was then used in the 107 (62%) patients who showed BP less of 140/90 mm Hg by CBP measurement. In only 73 patients the ABPM was conclusive of hypertension (145.8 +-11.4/87.8 +-8.4 mm Hg). In 34 patients the ABPM was normal (127.7+-5.5/75.6 +-5.3 mm Hg), thus establishing a diagnosis of WCH in these subjects. CONCLUSIONS: Only 42.5% of the patients had hypertension. More than half (57.5%) of the patients of the study group, previously diagnosed with hypertension, were not truly hypertensive. The ABPM identified 20% of patients with diagnosis incorrect, who had WCH. A combination of proper BP measurement techniques and the ABPM model can more accurately identify patients with hypertension.

blood pressure measurement, ambulatory blood pressure, hypertension diagnosis
This content is only available as a PDF.
© American Journal of Hypertension, Ltd. 2001
Topic:
Issue Section:
Abstracts
You do not currently have access to this article.
Download all slides