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- W2056550391 abstract "Significant “white-coat” hypertensive (WCH) effects present clinicians with troublesome management dilemmas. Further, “white coat” normotensive (WCN) effects have recently been described. The stability of WCH and WCN effects over a 1 year period was assessed by comparing clinic blood pressure (c-BP) with 24 hour (24h) and daytime (d) automatic ambulatory blood pressure (ABP) monitoring. 313 subjects with essential hypertension of >6 months duration on 2 drugs or less had at least 3 clinic BP measurements (Hg column) taken in a sitting position at a hospital-based hypertension clinic and a 24h ABP measurement on each of 3 occasions at 6 month intervals. ABP results were unavailable to clinicians. Threshold c-BP-minus-ABP differences of ≥+10/or/+5 and ≥+20/or/+10 mmHg for WCH and ≤−10/or/−5 mmHg for WCN were chosen to explore the stability of WCH and WCN effects. 298 subjects (95%) completed 1 year of follow up. Mean c-BP, 24h-ABP and d-ABP were 142/85, 132/81, and 137/85 at baseline (B); and 138/82, 131/80, and 135/84 after 6 (6m) and 12 months (12m) of follow up. Correlations between B and 6m and B and 12m clinic-ambulatory differences were highly statistically significant for all comparisons (p < 0.001 for all c-BP-ABP: 24h and d, SBP and DBP) but accounted for only 7–12% of variation (r = 0.26–0.35). At B, 58% and 27% of subjects exhibited 24h-WCH ≥+10/+5 and ≥+20/+10 mmHg, respectively; 40% and 18% exhibited d-WCH ≥+10/+5 and ≥+20/+10 mmHg, respectively. After 12m, 39% and 10% of these subjects exhibited 24h-WCHz ≥+10/+5 and ≥+20/+10 mmHg, respectively, on B, 6m and 12m measurements; 21% and 2% exhibited d-WCH ≥+10/+5 and ≥+20/+10 mmHg, respectively, on B, 6m and 12m measurements. At B, 15% exhibited 24h-WCN effect ≤−10/−5 mmHg and 27% exhibited d-WCN effect ≤−10/−5 mmHg. After 12m, 11% and 27% of these subjects exhibited 24h-WCN and d-WCN effect on B, 6m and 12m measurements. Single 24h-ABP measurements are insufficient to identify significant WCH and WCN effects and would lead to mislabeling in a lame proportion of hypertensive individuals." @default.
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- W2056550391 date "2000-06-01" @default.
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- W2056550391 title "How stable are white-coat hyper- and normotensive effects over time?" @default.
- W2056550391 doi "https://doi.org/10.1016/s0895-7061(00)00749-4" @default.
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