White-Coat Hypertension as a Risk Factor for the Development of Home Hypertension

Ugajin, Tomohisa; Hozawa, Atsushi; Ohkubo, Takayoshi; Asayama, Kei; Kikuya, Masahiro; Obara, Taku; Metoki, Hirohito; Hoshi, Hiroyuki; Hashimoto, Junichiro; Totsune, Kazuhito; Satoh, Hiroshi; Tsuji, Ichiro; Imai, Yutaka

doi:10.1001/archinte.165.13.1541

Cited by 135 publications

(96 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is no consensus on the prognosis of WCHT (32). Some investigators have reported that WCHT is likely to shift to PHT (33) or that the risk for stroke does not differ between WCHT and PHT, whereas other investigators have reported that the incidence of stroke is significantly lower among patients with WCHT (34).…”

Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Ambulatory BP Monitoring among Patients with CKD

Iimuro

Imai

Watanabe

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

. Data from 1075 patients (682 men) were analyzed to determine BP control and factors associated with the ABPM parameters.Results The prevalence of masked hypertension was 30.9%, whereas that of white-coat hypertension was 5.6%. With advancing CKD stage, the percentage of persistent hypertension increased from 21.7% to 36.1%. Diabetes, antihypertensive medicine use, and low estimated GFR (eGFR) were significantly associated with the difference between office BP and ambulatory BP (1.7 mmHg, 2.6 mmHg, and 0.6 mmHg per 10 ml/min per 1.73 m 2 , respectively). There tended to be fewer nondippers and risers in stage 3 than in stages 4 and 5. In the nocturianegative group, low eGFR, diabetes, and summer season were identified as factors associated with lower nocturnal BP change (20.5 mmHg, 22.0 mmHg, and 22.8 mmHg, respectively). Morning BP change was greater with older age (0.2 mmHg per 10 years) and higher body mass index (0.6 mmHg per 1 kg/m 2 ), and in winter (4.5 mmHg) versus summer.Conclusions Various factors including eGFR, diabetes, antihypertensive medication use, and season are associated with higher BP and abnormal BP patterns in CKD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Ambulatory BP Monitoring among Patients with CKD

Iimuro

Imai

Watanabe

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…7 Conversely, controversy remains about whether WCHT is a benign condition 8 or linked to an increased risk of target-organ damage and CVD. 9,10 Chronic kidney disease (CKD) is now considered as a major public health issue. The prevalence of end-stage renal disease is increasing in Japan, and is currently more than 2000 per million population.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of assessing masked and white-coat hypertension by ambulatory blood pressure monitoring for determining prevalent risk of chronic kidney disease: the Ohasama study

et al. 2010

Self Cite

View full text Add to dashboard Cite

Masked hypertension (MHT) is considered to be associated with organ damage, whereas the association of white-coat hypertension (WCHT) with organ damage remains controversial. Using home blood pressure measurements, we have previously reported that MHT is associated with a risk of chronic kidney disease (CKD) compared with sustained normal blood pressure (SNBP), although WCHT was not significantly related to CKD in a general Japanese population. The objective of this study was to examine CKD risk associated with WCHT and MHT as determined by ambulatory blood pressure (ABP) monitoring. Among 1023 residents in the general Japanese population of Ohasama, ABP and casual blood pressure (CBP) levels were recorded and blood and urine samples were collected. CKD was defined as a positive proteinuria and/or estimated glomerular filtration rate o60 ml min À1 per 1.73 m 2 . Participants were categorized into four groups using daytime ABP of 140/85 mm Hg and CBP of 140/90 mm Hg as cutoff points: SNBP, 60.0%; WCHT, 15.4%; MHT, 15.0%; and sustained hypertension (SHT), 9.6%. Odds ratios (ORs) for prevalence of CKD were calculated using a multiple logistic regression model. Compared with SNBP, risk of CKD was significantly higher in SHT (OR, 2.81; 95% confidence interval (CI), 1.66-4.75; P¼0.0001), MHT (OR, 2.29; 95% CI, 1.45-3.63; P¼0.0004) and WCHT (OR, 1.67; 95% CI, 1.03-2.71; P¼0.0368). CKD was significantly associated with MHT and WCHT on the basis of ABP monitoring compared with SNBP in the general Japanese population. Keywords: ambulatory blood pressure; chronic kidney disease; masked hypertension; white-coat hypertension INTRODUCTION Ambulatory blood pressure (ABP) has recently been the focus of large amounts of research, and the utility and usefulness of this technique have been recognized and established in the diagnosis and management of hypertension. 1-3 ABP is also considered as a useful tool for detecting overall blood pressure (BP) load, nighttime BP level and circadian and short-term variations in BP. These parameters contribute to the diagnosis and treatment of hypertension. [4][5][6] The measurement of ABP has enabled us to identify a subgroup of individuals with white-coat hypertension (WCHT), showing persistent hypertensive casual BP (CBP) but normal ABP, and a subgroup of individuals with masked hypertension (MHT), showing normal CBP but hypertensive ABP. MHT is reported to be associated strongly with high risk of

show abstract

Section: Prognozunclassified

“…15,16 Japonya'da yapılan Ohasama çalışmasında, BÖH hastalarının 10 yıl süreyle izleminde inme riskinde normotansiflere göre artış olmasına rağmen istatistiksel anlamlılık bulunmamıştır. 15 Pierdomenico ve ark.nın kardiyak ve serebrovasküler riski değerlendirmek için yaptıkları çalışmada 1732 hasta altı yıl süreyle takip edilmiş-tir. Hipertansif hastalarda kardiyak ve serebrovasküler riskin BÖH'li hastalara kıyasla daha fazla olduğu, BÖH ile normotansif hastalar arasında fark olmadığı, fakat BÖH'li hastaların normotansiflere göre izlem süresinde daha fazla antihipertansif tedaviye ihtiyaç duydukları saptanmıştır.…”

Section: Prognozunclassified

White-Coat Hypertension: Review

Cengiz¹,

Yavuzer²

2016

Turkiye Klinikleri J Intern Med

View full text Add to dashboard Cite

13Beyaz Önlük Hipertansiyonu Ö ÖZ ZE ET T Bu çalışmada, beyaz önlük hipertansiyonu (BÖH)'nun klinik ve laboratuvar yönlerini gün-cel bilgilerle açıklamak amaçlanmıştır. BÖH üzerine yapılan son klinik çalışmalar mevcut bilgilerimizle beraber irdelenmiştir. Avrupa Hipertansiyon Derneği tarafından 2013 yılında yayımlanan kılavuza göre; ofis tansiyon ölçümlerinin ≥140/90 mmHg, ev tansiyon ölçümlerinin ≤135/85 mmHg ve 24 saatlik ambulatuar kan basıncı ölçümlerinin ≤130/80 mmHg olması BÖH olarak tanımlan-maktadır. BÖH prevalansının %15-45 oranında olduğu, insidansının kadınlarda ve sigara içmeyen bireylerde daha yüksek olduğu bilinmektedir. BÖH hastalarında dislipidemi, bozulmuş açlık glukozu ve artmış sol ventrikül kitle indeksi normotansiflere göre daha fazla görülmektedir. Tüm klinisyenler, BÖH hastalarını özellikle uç organ hasarı ve metabolik sendrom gelişimleri açısından izlemeli ve BÖH'deki risk faktörleri açısından dikkatli olmalıdır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Beyaz önlük hipertansiyon; hipertansiyon A AB BS S T TR RA AC CT T This review aims to clarify novel concepts regarding the clinical and laboratory aspects of white-coat hypertension (WCHT). Recent studies on the clinical and biological implications of WCHT were compared with existing knowledge. WCHT patients were defined according to the 2013 European Society of Hypertension guidelines; an office blood pressure of ≥ 140/90 mmHg, a home blood pressure of ≤ 135/85 mmHg, and a mean 24-h ambulatory blood pressure of ≤130/80 mmHg. The reported prevalence of WCHT was 15%-45% and the incidence of WCHT tended to be higher in females and in non-smokers. Compared with normotensive patients, WCHT was associated with a higher left ventricular mass index, higher lipid levels, impaired fasting glucose, and decreased arterial compliance. Clinicians should be aware of the risk factors associated with WCHT and patients should be closely monitored especially to identify target organ damage and metabolic syndrome.K Ke ey y W Wo or rd ds s: : White-coat hypertension; hypertension T Tu ur r k ki i y ye e K Kl li i n ni ik k l le e r ri i J J I In nt te er rn n M Me ed d 2 20 01 16 6; ;1 1( (1 1) ): :1 13 3--6 6

show abstract

White-Coat Hypertension as a Risk Factor for the Development of Home Hypertension

Abstract: The results from the present 8-year follow-up study demonstrate that white-coat hypertension is a transitional condition to hypertension outside medical settings, suggesting that white-coat hypertension may carry a poor cardiovascular prognosis.

Cited by 135 publications

References 34 publications

Clinical Correlates of Ambulatory BP Monitoring among Patients with CKD

Clinical Correlates of Ambulatory BP Monitoring among Patients with CKD

Usefulness of assessing masked and white-coat hypertension by ambulatory blood pressure monitoring for determining prevalent risk of chronic kidney disease: the Ohasama study

White-Coat Hypertension: Review

Contact Info

Product

Resources

About