White-coat hypertension and normotension in the League of Hypertension of the Hospital das Clínicas, FMUSP: prevalence, clinical and demographic characteristics

• Main Author: Segre,Carlos A.
• Publication Date: 2003
• Other Authors: Ueno,Rubens K., Warde,Karim R. J., Accorsi,Tarso A. D., Miname,Márcio H., Chi,Chang K., Pierin,Angela M. G., Mion Júnior,Décio
• Format: Article
• Language: eng
• Source: Arquivos Brasileiros de Cardiologia (Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2003000200001
• topic: white-coat effect; white-coat hypertension; white-coat normotension

OBJECTIVE: To assess the prevalence of white-coat normortension, white-coat hypertension, and white-coat effect. METHODS: We assessed 670 medical records of patients from the League of Hypertension of the Hospital das Clínicas of the Medical School of the University of São Paulo. White-coat hypertension (blood pressure at the medical office: mean of 3 measurements with the oscillometric device <FONT FACE=Symbol>³</FONT>140 or <FONT FACE=Symbol>³</FONT>90 mmHg, or both, and ambulatory blood pressure monitoring mean during wakefulness < 135/85) and white-coat normotension (office blood pressure < 140/90 and blood pressure during wakefulness on ambulatory blood pressure monitoring <FONT FACE=Symbol>³</FONT> 135/85) were analyzed in 183 patients taking no medication. The white-coat effect (difference between office and ambulatory blood pressure > 20 mmHg for systolic and 10 mmHg for diastolic) was analyzed in 487 patients on treatment, 374 of whom underwent multivariate analysis to identify the variables that better explain the white-coat effect. RESULTS: Prevalence of white-coat normotension was 12%, prevalence of white-coat hypertension was 20%, and prevalence of the white-coat effect was 27%. A significant correlation (p<0.05) was observed between white-coat hypertension and familial history of hypertension, and between the white-coat effect and sex, severity of the office diastolic blood pressure, and thickness of left ventricular posterior wall. CONCLUSION: White-coat hypertension, white-coat normotension, and white-coat effect should be considered in the diagnosis of hypertension.