Faculty Opinions recommendation of Long-term prognostic value of white coat hypertension: an insight from diagnostic use of both ambulatory and home blood pressure measurements.

2013 ◽  
Author(s):  
Mahboob Rahman
Keyword(s):  
Blood Pressure ◽  
Prognostic Value ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Pressure Measurements ◽  
Diagnostic Use

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.

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.

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.

scholarly journals Patient Barriers and Facilitators to Ambulatory and Home Blood Pressure Monitoring: A Qualitative Study

2018 ◽  
Vol 31 (8) ◽  
pp. 919-927 ◽  
Author(s):  
Eileen J Carter ◽  
Nathalie Moise ◽  
Carmela Alcántara ◽  
Alexandra M Sullivan ◽  
Ian M Kronish
Keyword(s):  
Blood Pressure ◽  
New York ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Barriers And Facilitators ◽  
White Coat ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Monitoring Method

Abstract BACKGROUND Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. We explored patients’ perspectives of the barriers and facilitators to undergoing ABPM or HBPM. METHODS Focus groups were conducted with twenty English- and Spanish-speaking individuals from underserved communities in New York City. Two researchers analyzed transcripts using a conventional content analysis to identify barriers and facilitators to participation in ABPM and HBPM. RESULTS Participants described favorable attitudes toward testing including readily understanding white coat hypertension, agreeing with the rationale for out-of-office testing, and believing that testing would benefit patients. Regarding ABPM, participants expressed concerns over the representativeness of the day the test was performed and the intrusiveness of the frequent readings. Regarding HBPM, participants expressed concerns over the validity of the monitoring method and the reliability of home blood pressure devices. For both tests, participants noted that out-of-pocket costs may deter patient participation and felt that patients would require detailed information about the test itself before deciding to participate. Participants overwhelmingly believed that out-of-office testing benefits outweighed testing barriers, were confident that they could successfully complete either testing if recommended by their provider, and described the rationale for their testing preference. CONCLUSIONS Participants identified dominant barriers and facilitators to ABPM and HBPM testing, articulated testing preferences, and believed that they could successfully complete out-of-office testing if recommended by their provider.

scholarly journals REMAINING CARDIOVASCULAR RISK MARKERS IN PARTICIPANTS WITH WHITE-COAT HYPERTENSION DIAGNOSED BY HOME BLOOD PRESSURE RECORDINGS

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e13-e14
Author(s):  
Martina Johansson ◽  
Edvin Ström ◽  
Carl Johan Östgren ◽  
Jan Engvall ◽  
Magnus Wijkman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Risk Markers

scholarly journals White coat hypertension: current state of the issue

2021 ◽  
Vol 28 (2) ◽  
pp. 71-78
Author(s):  
K. H. Uvarova
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Treatment ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Prognostic Significance ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Lifestyle Modifications ◽  
Cardiovascular Morbidity And Mortality

More than 30 years have passed since the first description of such a concept as white coat hypertension was presented in the scientific literature, but since then, scientists are paying more and more attention to this condition. White coat hypertension is defined when the blood pressure readings obtained in the doctor’s office meet the criteria for hypertension, but the latter is not confirmed by outpatient or home blood pressure monitoring. Initially, the term was only applied to patients who had not received antihypertensive treatment, but recently this definition has been extended to people who regularly take drugs for lowering blood pressure, and this condition was called uncontrolled white coat hypertension. Some of the world’s most influential organizations in the field of cardiology have not reached a consensus on the definition of white coat hypertension on the background of common criteria, which has affected the differences in blood pressure thresholds according to outpatient monitoring. Quite a few studies in recent years have examined the clinical and prognostic significance of white coat hypertension in terms of its probable effects such as metabolic disorders, subclinical and extracardiac target organ damage, cardiovascular morbidity and mortality, and all-cause mortality. At present, there is no doubt that white coat hypertension is not an innocent condition; however, hypotheses about the prognostic role of this condition and the management of patients with white coat hypertension are still controversial. The question of treating white coat hypertension as a condition remains unsolved and requires further investigation. Today, it is considered most appropriate not to prescribe antihypertensive treatment to persons with office blood pressure at normal or below target levels, but to intensify lifestyle modifications and focus on reduction of cardiovascular risk.

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