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. 2018 Jul 6;20(8):1176-1182.
doi: 10.1111/jch.13330. Online ahead of print.

The importance of using 24-hour and nighttime blood pressure for the identification of white coat hypertension: Data from the Jackson Heart Study

D Edmund Anstey  1 , Lisandro D Colantonio  2 , Yuichiro Yano  3 , John N Booth Iii  2 , Paul Muntner  2
Affiliations

The importance of using 24-hour and nighttime blood pressure for the identification of white coat hypertension: Data from the Jackson Heart Study

D Edmund Anstey et al. J Clin Hypertens (Greenwich). .

Abstract

We calculated the prevalence of white coat hypertension (WCH) using out-of-clinic blood pressure (BP) in the daytime period; daytime and 24-hour periods; and daytime, 24-hour, and nighttime periods among 199 African Americans with clinic-measured systolic/diastolic BP ≥140/90 mm Hg in the Jackson Heart Study. Left ventricular mass index (LVMI) was measured among participants with WCH and 374 participants with sustained normotension (ie, non-hypertensive clinic, daytime, 24-hour, and nighttime BP). The prevalence of WCH was 29.6%, 21.1%, and 10.6% using daytime BP; daytime and 24-hour BP; and daytime, 24-hour, and nighttime BP, respectively. Compared with sustained normotension, LVMI was higher when WCH was defined using daytime BP (adjusted mean difference [95% CI] 5.0 [-0.2, 10.1] g/m2 ), but not when defined using daytime and 24-hour BP or daytime, 24-hour, and nighttime BP (adjusted mean difference [95% CI] 3.9 [-1.9, 9.7] and 0.4 [-7.3,8.2] g/m2 , respectively). Using only daytime BP overestimates the prevalence of WCH among African Americans.

Keywords: ambulatory blood pressure/home blood pressure monitor; clinical management of high blood pressure (HBP); hypertension in African Americans; hypertension-general; risk assessment.

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Conflict of interest statement

PM received an institutional grant from Amgen Inc. unrelated to the topic of the current manuscript. There are no other potential conflicts of interest.

Figures

Figure 1
Figure 1
Prevalence of white coat hypertension when out‐of‐clinic blood pressure was defined using the daytime; the daytime and 24‐h; and the daytime, 24‐h, and nighttime periods, separately. ABPM, Ambulatory blood pressure monitoring
See this image and copyright information in PMC

References

    1. Shimbo D, Abdalla M, Falzon L, Townsend RR, Muntner P. Role of ambulatory and home blood pressure monitoring in clinical practice: a narrative review. Ann Intern Med. 2015;163:691‐700. - PMC - PubMed
    1. Muntner P, Booth JN 3rd, Shimbo D, Schwartz JE. Is white‐coat hypertension associated with increased cardiovascular and mortality risk? J Hypertens. 2016;34:1655‐1658. - PubMed
    1. Briasoulis A, Androulakis E, Palla M, Papageorgiou N, Tousoulis D. White‐coat hypertension and cardiovascular events: a meta‐analysis. J Hypertens. 2016;34:593‐599. - PubMed
    1. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159‐2219. - PubMed
    1. Siu AL, U.S. Preventive Services Task Force . Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:778‐786. - PubMed