scholarly journals BLOOD PRESSURE VARIATION IN CHILDREN AT 5 MINUTE INTERVAL FOR IDENTIFICATION OF WHITE COAT HYPERTENSION

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Pradeep Sharan ◽  
Jai Prakash Narayan
Keyword(s):  
Blood Pressure ◽  
Hospital Stay ◽  
White Coat ◽  
White Coat Hypertension ◽  
Medical College ◽  
Minute Interval ◽  
Record Blood Pressure ◽  
The Difference ◽  
Stranger Anxiety ◽  
Doctor's Office

White-coat hypertension is a condition when a person’s blood pressure tends to increase only when they are at the doctor's office. In children, blood pressure between the 90th and 95th percentile is labelled as pre-hypertension and above the 95thcentile it is classified as hypertension. The difference between 90th and 95th centiles for both systolic and diastolic blood pressure is only 4 mm of Hg. Methods: Children between ages 5 to 10 years admitted in the children ward of Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India from February to April 2020 included in the study. We record blood pressure by oscillometer 4 times a day, over 4 days of hospital stay and each time two readings were taken at 5 minute intervals. Results: During 4 days of hospital stay blood pressure varied widely. In addition  second reading of BP were always less than the first reading BP,  but second readings data also varied widely just as first readings. Conclusion: White coat’ hypertension is the phenomenon where BP is exaggerated by act of measuring BP. This is initiated by anxiety. Children are particularly susceptible and distressed by the circumstances of hospitalization, stranger anxiety and fear to painful intervention. We should take multiple readings before reach a conclusion of hypertension.                  Key words: Blood pressure, White-coat Hypertension, Ambulatory BP, Hypertension

Abstract P124: Repeat Manual Office Blood Pressure By A Physician Is Lower Than Automated Office Blood Pressure

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Bryce Rhodehouse ◽  
Courtney Shaver ◽  
Jerry Fan ◽  
Bright Izekor ◽  
Clinton Jones ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vital Signs ◽  
Outpatient Setting ◽  
Office Blood Pressure ◽  
P Value ◽  
Signed Rank ◽  
Significant Difference ◽  
Minute Interval ◽  
The Difference ◽  
Automated Office Blood Pressure

Introduction: An accurate measurement of blood pressure (BP) is critical to diagnosing and treating hypertension (HTN). Manual office BP (MOBP) often results in higher readings than automated office BP (AOBP). In previous studies, a repeat MOBP by a physician resulted in a lower BP than the initial MOBP by nursing staff. We evaluated our hypothesis that a repeat MOBP by a physician is statistically equivalent to AOBP. Methods: In an ambulatory outpatient setting, patients were roomed and at least a 5-minute interval lapsed before an AOBP was performed using a Welch Allyn Connex Vital Signs Monitor. The physician was blinded to the AOBP. The physician then entered the room and obtained a MOBP with a manual aneroid sphygmomanometer. The difference between the AOBP and the MOBP was calculated. A Wilcoxon signed rank sum test was used to determine if a significant difference between AOBP and MOBP exists. Results: A total of 186 patients (112 females, 74 male) had BP measured with a mean age of 66 years. AOBP resulted in a median systolic BP (SBP) 136 mmHg (IQR 121-150 mmHg) and median diastolic BP (DBP) of 78 mmHg (IQR 72-85 mmHg). MOBP SBP had a median of 132 mmHg (IQR 120-142 mmHg) and DBP had a median of 76 mmHg (IQR 70-81 mmHg). SBP and DBP were significantly lower in the MOBP group with a mean difference between AOBP and MOBP of 4.0 and 2.7 mmHg respectively (p-value of <0.0001). Conclusions: Repeat MOBP performed by the physician resulted in a significantly lower BP compared to AOBP. The lower BP may be due to an overall longer interval between the AOBP measurement and MOBP measurement. MOBP may be a viable option for accurate diagnosis and treatment of HTN clinics without access to a AOBP machine.

scholarly journals Diagnosis of white-coat hypertension based solely on systolic blood pressure. The PIUMA study

2005 ◽  
Vol 18 (5) ◽  
pp. A46-A46 ◽  
Author(s):  
P VERDECCHIA ◽  
F ANGELI ◽  
G REBOLDI ◽  
R GATTOBIGIO ◽  
M SARDONE ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension

scholarly journals P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?

2020 ◽  
Vol 25 (Supplement 1) ◽  
pp. S155
Author(s):  
Fran Kirkham ◽  
GN Nuredini ◽  
A Saunders ◽  
Erin Drazich ◽  
Eva Bunting ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Pressure Management ◽  
Post Stroke ◽  
Blood Pressure Management ◽  
Intensive Blood Pressure

Abstract 11530: Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
David Conen ◽  
Stefanie Aeschbacher ◽  
Lutgarde Thijs ◽  
Yan Li ◽  
José Boggia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Population Based ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Daytime Blood Pressure ◽  
Collaborative Analysis ◽  
The Individual ◽  
Age Range ◽  
Diagnosis Of Hypertension

Introduction: Mean daytime ambulatory blood pressure (ABP) values are considered to be lower than conventional BP (CBP) values, but data on this relation among younger individuals <50 years are scarce. To address this issue, we performed a collaborative analysis in a large group of participants representing a wide age range. Methods: CBP and 24-hour ABP were measured in 9550 individuals not taking BP lowering treatment from 13 population based cohorts. We compared the individual differences between daytime ABP and CBP according to 10-year age categories. Age-specific prevalences of white-coat hypertension and masked hypertension were calculated based on guideline-recommended thresholds. Results: Among individuals aged 18-30, 30-40 and 40-50 years, mean daytime systolic and diastolic ABP were significantly higher than the corresponding CBP (6.0, 5.2 and 4.7 mmHg for systolic BP; 2.5, 2.7 and 1.7 mmHg for diastolic BP, all p<0.0001) (Figure). Systolic and diastolic BP indices were similar in participants aged 50-60 years (p=0.20 and 0.11, respectively). In individuals aged 60-70 and ≥70 years, CBP was significantly higher than daytime ABP (5.0 and 13.0 mmHg for systolic BP; 2.0 and 4.2 mmHg for diastolic BP, all p<0.0001) (Figure). Accordingly, the prevalence of white coat hypertension exponentially increased from 2.2% to 19.5% from those aged 18-30 years to those aged ≥70 years, with some variation between men and women (prevalence 8.0% versus 6.1%, p=0.0003). Masked hypertension was more prevalent among men (21.1% versus 11.4%, p<0.0001). The age-specific prevalence of masked hypertension was 18.2%, 27.3%, 27.8%, 20.1% 13.6% and 10.2% in men, and 9.0%, 9.9%, 12.2%, 11.9%, 14.7% and 12.1% in women. Conclusions: In this large collaborative analysis we found that the relation between daytime ABP and CBP strongly varies by age. These findings may have important implications for the diagnosis of hypertension and its subtypes in clinical practice.

Abstract 2745: Diagnostic Algorithm Using Office and Home Blood Pressures to Exclude White Coat Hypertension

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sujith Kuruvilla ◽  
Kiran Nallella ◽  
Anne Mani ◽  
Geetha Pinto ◽  
Daichi Shimbo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sensitivity And Specificity ◽  
Diagnostic Algorithm ◽  
White Coat ◽  
White Coat Hypertension ◽  
Clinic Blood Pressure ◽  
Cutoff Value ◽  
Sustained Hypertension ◽  
Traditional Algorithm ◽  
Blood Pressures

Background: It has been suggested that the diagnosis of sustained hypertension (SHTN), defined as clinic blood pressure (CBP) ≥140 or ≥90 mmHg plus a daytime ambulatory BP (ABP) ≥135 or ≥85 mmHg can be optimized by taking home BP (HBP) in those with high CBP, and obtaining ABP only if HBP is normal (<135/85). This study tested whether a higher cutoff value for CBP using Receiver Operator Curves (ROC) based on systolic and diastolic CBP for the diagnosis of SHT (95% specificity) would improve the efficiency of the algorithm for diagnosing SHT and reduce the number of subjects requiring HBP and ABP to establish the diagnosis. Methods and Results: We assessed CBP, ABP and HBP in 229 normotensive and untreated hypertensive subjects. CBP was high in 84 subjects. Of these, 74 (88%) had SHTN, and 10 (12%) white coat HTN (WCH- high CBP but normal ABP). With HBP, 69 (82%) had high HBP, and of these 63 (91%) had SHT. Based on traditional algorithm, 15 subjects require ABP monitoring to diagnose SHT, which would be confirmed in 11. Using the ROC algorithm, 55 of 84 subjects (50 SHT; 5 WCH) would be classified as ``hypertensive” (at or above the CBP cut-off); 29 subjects would fall below the cut-off and require HBP (with 24 having SHT); 5 subjects would require ABP. The sensitivity and specificity for diagnosing SHT were 100% and 40% for the traditional algorithm, and 100% and 20% for the ROC algorithm. Conclusions: The ROC algorithm is as effective as the traditional algorithm for diagnosing SHT, and requires fewer HBPs (29 vs. 84) and ABPs (5 vs. 15). Therefore, this algorithm may have widespread indications for the screening of ambulatory hypertension.

scholarly journals Hypertension Subtypes among Thai Hypertensives: An Analysis of Telehealth-Assisted Instrument in Home Blood Pressure Monitoring Nationwide Pilot Project

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Sakolwat Montrivade ◽  
Pairoj Chattranukulchai ◽  
Sarawut Siwamogsatham ◽  
Yongkasem Vorasettakarnkij ◽  
Witthawat Naeowong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Demographic Data ◽  
Real Life ◽  
Antihypertensive Agents ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Routine Practice ◽  
White Coat Effect

Background. White-coat hypertension (HT), masked HT, HT with white-coat effect, and masked uncontrolled HT are well-recognized problems of over- and undertreatment of high blood pressure in real-life practice. However, little is known about the true prevalence in Thailand. Objectives. To examine the prevalence and characteristics of each HT subtype defined by mean home blood pressure (HBP) and clinic blood pressure (CBP) using telemonitoring technology in Thai hypertensives. Methods. A multicenter, observational study included adult hypertensives who had been diagnosed for at least 3 months based on CBP without the adoption of HBP monitoring. All patients were instructed to manually measure their HBP twice a day for the duration of at least one week using the same validated automated, oscillometric telemonitoring devices (Uright model TD-3128, TaiDoc Corporation, Taiwan). The HBP, CBP, and baseline demographic data were recorded on the web-based system. HT subtypes were classified according to the treatment status, CBP (≥or <140/90 mmHg), and mean HBP (≥or <135/85 mmHg) into the following eight subtypes: in nonmedicated hypertensives, there are four subtypes that are normotension, white-coat HT, masked HT, and sustained HT; in treated hypertensives, there are four subtypes that are well-controlled HT, HT with white-coat effect, masked uncontrolled HT, and sustained HT. Results. Of the 1,184 patients (mean age 58 ± 12.7 years, 59% women) from 46 hospitals, 1,040 (87.8%) were taking antihypertensive agents. The majority of them were enrolled from primary care hospitals (81%). In the nonmedicated group, the prevalence of white-coat and masked HT was 25.7% and 7.0%, respectively. Among the treated patients, the HT with white-coat effect was found in 23.3% while 46.7% had uncontrolled HBP (a combination of the masked uncontrolled HT (9.6%) and sustained HT (37.1%)). In the medicated older subgroup (n = 487), uncontrolled HBP was more prevalent in male than in female (53.6% vs. 42.4%, p=0.013). Conclusions. This is the first nationwide study in Thailand to examine the prevalence of HT subtypes. Almost one-fourth had white-coat HT or HT with white-coat effect. Approximately half of the treated patients especially in the older males had uncontrolled HBP requiring more intensive interventions. These results emphasize the role of HBP monitoring for appropriate HT diagnosis and management. The cost-effectiveness of utilizing THAI HBPM in routine practice needs to be examined in the future study.

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