Some studies reported that home blood pressure (HBP) monitoring was conducted by community-dwelling older people themselves, but there have been few studies on HBP including very old populations aged over 90 years old. Thus, the aim of the present study was to clarify the current situation of white-coat and masked phenomena defined by on-site and home BP measurements in community-dwelling old and oldest-old populations. The study subjects were 380 participants from the SONIC study, a cohort study of a community-dwelling old population, who measured their HBP in a series of 3–5 days by themselves and brought their HBP records to the venue on the survey day. Study participants’ characteristics were as follows: female, 185 (48.7%); male, 195 (51.3%); 70s, 95 (25.0%); 80s, 245 (64.5%); and 90s, 40 (10.5%). A total of 344 (90.5%) participants had hypertension. A total of 291 (76.6%) hypertensive participants taking antihypertensive medication were analyzed in the present study. Regarding the types of hypertension defined by home and on-site BP, they showed white-coat phenomenon, 183 (48.2%); masked phenomenon, 115 (30.3%); sustained hypertension, 130 (34.2%); and normotension, 82 (21.6%). On comparison of age groups, there was a tendency for the white-coat phenomenon to be common in young-old people in their 70s and the masked phenomenon to be common in very old people in their 90s. Therefore, since the detection of white-coat and masked phenomena is closely associated with appropriate BP management, it is very important for community-dwelling older populations to self-monitor HBP.
A 48‐year‐old female patient was hospitalized for 5 days after a cold. Encephalitis was considered after preliminary history and routine examination, but the patient did not show significant improvement after antiviral treatment. At this time, magnetic resonance imaging indicated pituitary atrophy, and the patient's medical history was assessed. She had a history of postpartum bleeding and amenorrhea 15 years ago. The supplementary examination indicated hormonal abnormalities. These suggested that the patient may have had Sheehan's syndrome (SS). After hormone supplementation treatment for 10 days, her condition improved. This case suggested that in female patients with neuropsychiatric disorders with a history of previous postpartum hemorrhage, attention needs to be paid to screening for SS to improve the related diagnosis and treatment rate.
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