Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension
- 1 March 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 59 (3), 564-571
- https://doi.org/10.1161/hypertensionaha.111.180653
Abstract
The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (≥90 mm Hg) or by daytime ABP (≥85 mm Hg), a history of cardiovascular disease, and persons P=0.29). Furthermore, in treated subjects with isolated systolic hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79–1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43–2.79]; PP<0.0001) were at higher risk as compared with untreated normotensive subjects. In conclusion, subjects with sustained hypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, “treated normalized hypertension.” Therefore, one should be cautious in applying the term “white-coat hypertension” to persons receiving antihypertensive treatment.Keywords
This publication has 41 references indexed in Scilit:
- The Relationship Between Visit-to-Visit Variability in Systolic Blood Pressure and All-Cause Mortality in the General PopulationHypertension, 2011
- Measurement of Blood Pressure in the OfficeHypertension, 2010
- Cardiovascular and Metabolic Predictors of Progression of Prehypertension Into HypertensionHypertension, 2009
- Home Blood Pressure Measurements Will Not Replace 24-Hour Ambulatory Blood Pressure MonitoringHypertension, 2009
- Single Versus Combined Blood Pressure Components and Risk for Cardiovascular DiseaseCirculation, 2009
- Long-Term Risk of Mortality Associated With Selective and Combined Elevation in Office, Home, and Ambulatory Blood PressureHypertension, 2006
- Ambulatory Blood Pressure and MortalityHypertension, 2005
- Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureHypertension, 2003
- Ambulatory Blood PressureHypertension, 1999
- Pulse PressureHypertension, 1997