P0149PREVALENCE OF MASKED HYPERTENSION IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ekaterina Borodulina ◽  
Alexander M Shutov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Home Blood Pressure ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Measurements

Abstract Background and Aims Arterial hypertension is main cause of left ventricular hypertrophy (LVH) in hemodialysis patients. Masked hypertension is associated with asymptomatic organ damage, including the development of LVH. The aim of this study was to investigate the prevalence of white-coat hypertension and masked hypertension in hemodialysis patients. Method Hemodialysis patients (n=88; 42 males, 46 females, mean age was 51.7±13.3 years) were studied. Office blood pressure measurements were performed before and after hemodialysis within 30 days. Home Blood Pressure Measurements (HBPM) was collected in the morning and in the evening during 4 weeks including hemodialysis session days. 24 hours blood pressure monitoring (ABPM) was performed in the next day after hemodialysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) were analyzed. White-coat hypertension was diagnosed when blood pressure elevated in the office, but was normal when was measured by ABPM, HBPM, or both. Masked hypertension was determined when blood pressure was normal in the office, but increased when was measured by HBPM or ABPM. The definitions of the European Society of Cardiology (2018 ESC/ESH Guidelines for the management of arterial hypertension) were used for the diagnosis of hypertension according to office, ambulatory, and home blood pressure levels. Echocardiographic evaluation was performed on the day after dialysis and left ventricular mass index (LVMI) was calculated. Results Arterial hypertension was diagnosed by office blood pressure measurements in 39 (44.3%) patients. Arterial hypertension was defined by ABPM (mean 24h BP > or = 130 and 80 mmHg) in 48 (54.5%) patients. The number of non-dipper patients was 59 (67.0%). According to HBPM arterial hypertension was observed in 61 (69.3%) patients. Left ventricular hypertrophy was detected in 71 (80.7%) patients. Mean LVMI was 140.5±43.0 g/m2. According to the results of three methods of blood pressure measuring arterial hypertension was diagnosed in 53 (60.2%) patients, white-coat hypertension was observed in 5 (5.7%) patients, masked hypertension – in 19 (21.6%) patients. Conclusion According to office blood pressure measurements arterial hypertension was diagnosed in 44.3% hemodialysis patients. Masked hypertension was often observed in hemodialysis patients and when using not only ABPM, but also HBPM was detected in 21.6% of patients. The results indicate the importance of using not only ABPM, but also HBPM in hemodialysis patients.

scholarly journals Prevalence of sustained arterial hypertension, white coat hypertension and masked hypertension among working women

2012 ◽  
Vol 93 (5) ◽  
pp. 826-829 ◽  
Author(s):  
E Y Kalcheva ◽  
V N Oslopov ◽  
O V Zakharova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
White Coat ◽  
White Coat Hypertension ◽  
Study Cohort ◽  
Masked Hypertension ◽  
Pressure Measurements ◽  
Employed Women

Aim. The prevalence of sustained arterial hypertension, white coat hypertension (isolated clinical arterial hypertension) and masked hypertension (isolated ambulatory arterial hypertension) among employed women of Kazan was studied. Cardiovascular risk factors in these conditions were evaluated. Methods. The study cohort included 108 patients. The examination was conducted at the jobsite and included questionnaires, blood pressure measurements, anthropometry, fasting glucose level and lipid profile examination. Assessment of blood pressure in everyday conditions was performed by 24-hour monitoring of blood pressure or home blood pressure measurements over 4 days. Results. The prevalence of sustained hypertension in the study cohort was 31.6%, white-coat hypertension - 4.6%, masked hypertension - 13.9%. Among patients with white coat hypertension and masked hypertension most of the patients had two or more cardiovascular risk factors; the distribution of risk factors number in these groups was similar to a group of patients with sustained hypertension. Conclusion. Among the employed women the prevalence of sustained arterial hypertension was high, the prevalence of masked hypertension was quite high, the prevalence of white coat hypertension was lower than expected.

scholarly journals Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Thunyarat Anothaisintawee ◽  
Auttakiat Karnjanapiboonwong ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Odds Ratio ◽  
Diagnostic Odds Ratio ◽  
Home Blood Pressure ◽  
White Coat ◽  
Masked Hypertension ◽  
Pressure Measurements ◽  
Pooled Prevalence ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background This systematic review aimed to estimate the performance of clinic(CBPM) and home blood pressure measurements(HBPM) compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of white coat and masked hypertension.Methods Medline and Scopus databases were searched up to 11th June 2018. Studies having diagnostic test as CBPM or HBPM, reference standard as ABPM, and reported sensitivity and specificity of either or both tests and/or proportion of white coat or masked hypertension were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of white coat and masked hypertension.Results Forty-six studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 66%(95%CI:58%-73%), 83%(95%CI:75%-89%), and 9.75(95%CI:6.45-14.74), respectively. Pooled prevalence of white coat and masked hypertension were 31%(95%CI:26%-35%) and 25%(95%CI:22%-28%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 71%(95%CI:58%-80%), 84%(95%CI:73%-91%), and 12.47(95%CI:6.13-25.37), respectively. Pooled prevalence of white coat and masked hypertension were 19%(95%CI:10%-27%) and 31%(95%CI:10%-52%).Conclusions Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of masked hypertension was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.

scholarly journals Comparison Between Automated Office Blood Pressure Measurements and Manual Office Blood Pressure Measurements—Implications in Individual Patients: a Systematic Review and Meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yacong Bo ◽  
Kin-On Kwok ◽  
Kareen Ka-Yin Chu ◽  
Eppie Yu-Han Leung ◽  
Chun Pong Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
White Coat ◽  
Accurate Estimation ◽  
Masked Hypertension ◽  
Pressure Measurements ◽  
High Quality ◽  
Automated Office Blood Pressure

Abstract Purpose of Review Automated office blood pressure (AOBP) measurements may provide more accurate estimation of blood pressure (BP) than manual office blood pressure (MOBP) measurements. This systematic review investigated the diagnostic performance of AOBP and MOBP using ambulatory blood pressure measurement (ABPM) as reference. Several databases including MEDLINE, Embase, Scopus, and China Academic Journals were searched. Data were extracted, double-checked by two investigators, and were analysed using a random effects model. Recent Findings A total of 26 observational studies were included. The mean systolic/diastolic BP obtained by AOBP was not significantly different from that obtained by ABPM. The sensitivity and specificity of AOBP to detect elevated BP were approximately 70%. Fewer participants had white-coat hypertension on AOBP measurement than on MOBP measurement (7% versus 14%); however, about 13% had masked hypertension on AOBP measurement. The width of the limit of agreement comparing (i) AOBP and ABPM and (ii) MOBP and ABPM was comparable. Summary AOBP may reduce the rate of the observed white-coat effect but undermine masked hypertension. The current recommendation, however, is limited by the absence of high-quality studies and the high heterogeneity of our results. More high-quality studies using different AOBP machines and in different population are therefore needed.

Prevalence and risk factors of white-coat hypertension and masked hypertension in Shunde District,Southern China:Observational Study (Preprint)

2021 ◽  
Author(s):  
Yuli Huang ◽  
Haoxiao Zheng ◽  
Xiaoyan Liang ◽  
Chunyi Huang ◽  
Lichang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Family History ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
History Of

BACKGROUND White-coat hypertension (WCH) and masked hypertension (MH) can increase the risk of target organ damage. Home blood pressure monitoring is an important method for detecting WCH and MH. However, the prevalence and risk factors of WCH and MH in China has been rarely reported. OBJECTIVE To explore the prevalence and risk factors associated with white coat hypertension (WCH) and masked hypertension (MH) in Shunde District, Southern China. METHODS This study recruited subjects from the Physical Examination Center in Shunde Hospital, Southern Medical University. Office blood pressure and home blood pressure values were collected. The prevalence of WCH and MH was calculated by combining the office blood pressure and home blood pressure values. Multivariate logistic regression was used to explore the related risk factors for WCH and MH. RESULTS Four-hundred and sixty-one participants (61% male), with an average age of 49 years, were included. The incidence of WCH and MH was 5.1% and 15.2%, respectively. Multivariate logistic regression analysis showed that smoking (OR=4.71, 95%CI=1.05-21.15) and family history of coronary heart disease (OR=4.51, 95%CI=1.08-18.93) were associated with higher odds of WCH. The associated factors for higher odds of MH were smoking (OR=2.83, 95%CI=1.11-7.23), family history of hypertension (OR=2.17, 95%CI=1.11-4.26) and family history of coronary heart disease (OR=2.82, 95%CI=1.07-7.45). CONCLUSIONS WCH and MH are highly prevalent in the health check-up population in Southern China. Out-of-office blood pressure monitoring, especially home blood pressure monitoring with a telemedicine device should be recommended to identity abnormal BP phenotype. CLINICALTRIAL It has been registered in the Chinese Clinical Trial Registry(ChiCTR1800018515)

scholarly journals Clinical and psychological aspects of true arterial hypertension and white coat hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Legkonogov ◽  
E Sokolovskaya
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
White Coat ◽  
Psychological Status ◽  
White Coat Hypertension ◽  
Control Group ◽  
Personality Profiles ◽  
Healthy Individuals

Abstract Purpose To compare the clinical and psychological features, as well as echocardiographic and ambulatory blood pressure monitoring (ABPM) data in patients with true arterial hypertension (AH) and white coat hypertension (WCH). Methods Were studied 154 subjects (58 men and 96 women, average age 52.9±0.7 years) with increased office blood pressure. The control group consisted of 31 healthy individuals (12 men and 19 women, average age 51.5±2.4 years). All individuals underwent ABPM, Doppler echocardiography, and psychological status studies using the MMPI and Spielberger tests. Results ABPM confirmed the presence of AH in 127 (47 men and 80 women, average age 53.3±0.8 years) of 154 examined patients. 27 patients (17.5%) were diagnosed with WCH - 11 men and 16 women, the average age of 50.8±1.4 years. Among healthy individuals, dippers prevailed, while among AH patients the proportion of dippers was significantly lower (p<0.001) compared with the control group, and a larger number of non-dippers, over-dippers and night-peakers was noted (p<0.01). The distribution of patients with WCH by the type of the daily profile of blood pressure (BP) did not significantly differ from that in healthy individuals (p>0.05). Patients with AH compared with healthy patients had higher average values of the left ventricular (LV) posterior wall as well as interventricular septum thickness, left atrium diameter, and LV myocardial mass index. We found no signs of LV hypertrophy in WCH patients and healthy individuals. The correlation analysis confirmed a reliable relationship between most echocardiographic parameters and ABPM in AH patients (p<0.05). The results of the MMPI and Spielberger tests revealed higher levels of reactive and personal anxiety in patients with AH compared with healthy individuals. Patients with WCH were characterized by disharmonious personality profiles and, in comparison with the control group, more pronounced hypochondriac, hysteroid, and psychasthenic features. Compared with AH patients, subjects with WCH were characterized by less pronounced depression, isolation, rigidity of anxious affect, as well as a more pronounced demonstrative behavior. Conclusions In people with AH patients the structural and functional characteristics of the heart there correlate with the ABPM results. In contrast, echocardiographic findings in individuals with WCH do not significantly differ from those in healthy subjects. Individuals with WCH have more pronounced hypochondriacs, anxious-suspicious and hysteroid personality traits, while for patients with AH depression, isolation, and rigidity of anxious affect are more common. Funding Acknowledgement Type of funding source: None

Two-day home blood pressure monitoring may offer an alternative to costlier methods

2018 ◽  
Vol 4 (2) ◽  
pp. 84-90
Author(s):  
Gavin Devereux ◽  
Daniel Gibney ◽  
Fiqry Fadhlillah ◽  
Paul Brown ◽  
Neil Macey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Measurements ◽  
Pressure Monitoring ◽  
Time Saving ◽  
Home Based

BackgroundKey benefits of home-based blood pressure measurements are the potential to reduce the risk of ‘white coat hypertension’, encouraging patients to take ownership of their condition and be more actively involved in their long-term condition care, and to move work out of the doctor’s office.AimTo assess whether performing 20 resting blood pressure measurements over a 2-day period would provide a reliable, stable representation of patients’ resting systolic and diastolic blood pressure. Following clinician recommendation, each participant completed the Stowhealth home blood pressure monitoring procedure.MethodOne thousand and forty-five participants (mean age 66±13 years, 531 women and 514 men) completed the procedure, of 10 resting measurements per day, for 2 days (20 resting systolic and diastolic blood pressure readings in total). All measurements were made using automated oscillometric monitors.ResultsWithin-patient coefficient of variation for the entire participant cohort was 8% for systolic blood pressure (cohort mean 141±11 mm Hg), and 8% for diastolic blood pressure (cohort mean 79±6 mm Hg). There were no significant differences between the first and second day, for either systolic (142±1vs 141±1 mm Hg, respectively, p>0.05) or diastolic blood pressures (79±1vs 78±1 mm Hg, respectively, p>0.05 in both cases).ConclusionThe overall duration of home blood pressure monitoring may be able to be reduced to just 48 hours. This method would offer meaningful time saving for patients, and financial and time benefits for doctors and their surgery administration.

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