Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

Kang, In Sook; Pyun, Wook Bum; Shin, Jinho; Ihm, Sang Hyun; Kim, Ju Han; Park, Sungha; Kim, Kwang Il; Kim, Woo Shik; Kim, Soon Gil; Shin, Gil Ja

doi:10.4070/kcj.2016.46.3.365

Cited by 8 publications

(6 citation statements)

References 30 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[33][34][35] BP variability depends on sympathetic vascular modulation and changes in arterial distensibility. Higher shortterm BP variability in subjects with white-coat hypertension than in those with normotension has been reported in a few other studies 38,39 and may be intrinsic or an enhanced stress response to external stimuli. Alternatively, it may reflect a diffuse atherosclerotic process induced by aging and hypertension that leads to increased 9 stiffness of the large elastic arteries and/or depressed baroreflex functions causing impaired cardiovascular control mechanisms.…”

supporting

confidence: 51%

Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain

et al. 2017

View full text Add to dashboard Cite

El acceso a la versión del editor puede requerir la suscripción del recurso Access to the published version may require subscription Three observer-measured home BPs and 24-hour ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP standard deviation and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime, and nighttime systolic BP standard deviations and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (p<0.05) and were similar to subjects with sustained hypertension. In untreated subjects, 24-hour but not daytime or nighttime BP variability indexes were significantly higher in subjects with white-coat hypertension than in those with normotension (p<0.05). Percentage decrease in nocturnal systolic and diastolic BP was greatest in the white-coat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (p<0.05). Lack of nocturnal decline in systolic blood pressure was observed in 70.2% of subjects with normotension, 57.8% of subjects with white-coat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (p<0.001). In conclusion, 24-hour BP variability was higher in subjects with white-coat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased cardiovascular risk in patients with white-coat hypertension and poor prognosis in those with masked hypertension, highlighting the importance of ABPM.

show abstract

supporting

confidence: 51%

Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Office BP was measured using a UA-767 monitor (A&D Co., Ltd., Tokyo, Japan), which had passed the European Hypertension Society protocol at all institutions. Office BP was determined as the mean BP of two measurements taken at 1 minute intervals with a 5-minute rest before the first measurement [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical features and predictors of masked uncontrolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry

Kim

Shin

Lee

et al. 2021

Korean J Intern Med

Self Cite

View full text Add to dashboard Cite

Background/Aims: The clinical characteristics of patients with masked uncontrolled hypertension (MUCH) have been poorly defined, and few studies have investigated the clinical predictors of MUCH. We investigated the demographic, clinical, and blood pressure (BP) characteristics of patients with MUCH and proposed a prediction model for MUCH in patients with hypertension. Methods: We analyzed 1,986 subjects who were enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) Registry and taking antihypertensive drugs, and classified them into the controlled hypertension (n = 465) and MUCH (n = 389) groups. MUCH was defined as the presence of a 24-hour ambulatory mean systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 80 mmHg in patients treated with antihypertensive drugs, having normal office BP. Results: Patients in the MUCH group had significantly worse metabolic profiles and higher office BP, and took significantly fewer antihypertensive drugs compared to those in the controlled hypertension group. Multivariate logistic regression analyses identified high office systolic BP and diastolic BP, prior stroke, dyslipidemia, left ventricular hypertrophy (LVH, ≥ 116 g/m 2 for men, and ≥ 96 g/m 2 for women), high heart rate (≥ 75 beats/min), and single antihypertensive drug use as independent predictors of MUCH. A prediction model using these predictors showed a high diagnostic accuracy (C-index of 0.839) and goodness-of-fit for the presence of MUCH. Conclusions: MUCH is associated with a high-normal increase in office BP and underuse of antihypertensive drugs, as well as dyslipidemia, prior stroke, and LVH, which could underscore achieving optimal BP control. The proposed model accurately predicts MUCH in patients with controlled office BP.

show abstract

“…In the context of BPV, a new way of looking at white coat hypertension could be described as increased BPV with normal out‐of‐office BP, and masked hypertension could be described as increased BPV and elevated out‐of‐office BP . From a therapeutic perspective, white coat hypertension is considered to be benign, but the detection of masked hypertension is essential because it is associated with significantly increased cardiovascular risk if undetected .…”

Section: Blood Pressure Variabilitymentioning

confidence: 99%

Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network

Sogunuru

Kario

Shin

et al. 2018

J of Clinical Hypertension

Self Cite

View full text Add to dashboard Cite

Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases.To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio-and cerebrovascular events, and end-organ damage. | 325 SOGUNURU et al.external behavioral and environmental factors. Therefore, a holistic approach to primary and secondary prevention is essential for avoiding end-organ damage. Although there are inconsistencies in current definitions and parameters of BPV, ongoing and future research should facilitate better scientific understanding, which in turn will help to optimize strategies for the detection and treatment of arterial hypertension to reduce adverse outcomes. Existing available technology and future advances in digital non-invasive miniaturized sensors could help early detection of hypertension and its variability for planning appropriate therapeutic strategies. ACK N OWLED G M ENTSEditing assistance was provided by Nicola Ryan, independent medical writer, funded by Pfizer.

show abstract

Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

Cited by 8 publications

References 30 publications

Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain

Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain

Clinical features and predictors of masked uncontrolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry

Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network

Contact Info

Product

Resources

About