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Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension: A Meta-Analysis Using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Population

Hypertension (Dallas, Tex. 1979), 2012-03, Vol.59 (3), p.564-571 [Peer Reviewed Journal]

2012 American Heart Association, Inc. ;2015 INIST-CNRS ;Copyright © 2012 American Heart Association. All rights reserved. 2012 ;ISSN: 0194-911X ;ISSN: 1524-4563 ;EISSN: 1524-4563 ;DOI: 10.1161/HYPERTENSIONAHA.111.180653 ;PMID: 22252396 ;CODEN: HPRTDN

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Title:
Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension: A Meta-Analysis Using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Population
Author: Franklin, Stanley S ; Thijs, Lutgarde ; Hansen, Tine W ; Li, Yan ; Boggia, José ; Kikuya, Masahiro ; Björklund-Bodegård, Kristina ; Ohkubo, Takayoshi ; Jeppesen, Jørgen ; Torp-Pedersen, Christian ; Dolan, Eamon ; Kuznetsova, Tatiana ; Stolarz-Skrzypek, Katarzyna ; Tikhonoff, Valérie ; Malyutina, Sofia ; Casiglia, Edoardo ; Nikitin, Yuri ; Lind, Lars ; Sandoya, Edgardo ; Kawecka-Jaszcz, Kalina ; Imai, Yutaka ; Wang, Jiguang ; Ibsen, Hans ; OʼBrien, Eoin ; Staessen, Jan A
Subjects: ambulatory blood pressure ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; cardiovascular disease ; epidemiology ; Global Health ; Humans ; Hypertension - epidemiology ; Hypertension - physiopathology ; Incidence ; isolated systolic hypertension ; Population Surveillance ; Systole ; White Coat Hypertension - epidemiology ; White Coat Hypertension - physiopathology ; white-coat effect ; white-coat hypertension
Is Part Of: Hypertension (Dallas, Tex. 1979), 2012-03, Vol.59 (3), p.564-571
Description: 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 <18 years of age, the present analysis totaled 7295 persons, of whom 1593 had isolated systolic hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP ≥140/<90 mm Hg and ABP <135/<85 mm Hg) and subjects with normal BP (CBP <140/<90 mm Hg and ABP <135/<85 mm Hg) were at similar risk (adjusted hazard rate1.17 [95% CI0.87–1.57]; 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 rate1.10 [95% CI0.79–1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate2.00; [95% CI1.43–2.79]; P<0.0001) and treated subjects with normal BP (adjusted hazard rate1.98 [95% CI1.49–2.62]; P<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.
Publisher: Hagerstown, MD: American Heart Association, Inc
Language: English;Russian
Identifier: ISSN: 0194-911X
ISSN: 1524-4563
EISSN: 1524-4563
DOI: 10.1161/HYPERTENSIONAHA.111.180653
PMID: 22252396
CODEN: HPRTDN
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE

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Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension: A Meta-Analysis Using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Population

2012 American Heart Association, Inc. ;2015 INIST-CNRS ;Copyright © 2012 American Heart Association. All rights reserved. 2012 ;ISSN: 0194-911X ;ISSN: 1524-4563 ;EISSN: 1524-4563 ;DOI: 10.1161/HYPERTENSIONAHA.111.180653 ;PMID: 22252396 ;CODEN: HPRTDN

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