Clinical characteristics of isolated clinic hypertension

Vinyoles, Ernest; Felip, A.; Pujol, Enriqueta; Sierra, Alejandro de la; Dura, Rafael; Rey, R. Hernández del; Sobrino, Javier; Gorostidi, Manuel; Figuera, Mariano de la; Segura, Julián; Banegas, José R.; Ruilope, Luís M.

doi:10.1097/hjh.0b013e3282f3150b

Cited by 52 publications

(31 citation statements)

References 39 publications

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“…This condition is associated with an intermediate risk of cardiovascular events between those with sustained hypertension and normotensive individuals, and it is described to be particularly frequent in women. 35 However, we excluded participants with suspected white coat hypertension, and the vast majority of them had been treated for a long time before inclusion, thus making this possibility less likely.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

et al. 2014

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“…With the widening gap between CBP and ABP with advancing age, the 2 arbitrary definitions of hypertension diverge, and it is unlikely that the present definition of WCH is appropriate over 80 years of age. Indeed, it is recognized that the prevalence of WCH increases with age, [17][18][19][20][21] and the possibility remains that many with this condition would benefit from treatment. A recent database analysis reported a 28.6% prevalence of WCH in subjects with isolated systolic hypertension and an average of 60 years of age.…”

Section: Discussionmentioning

confidence: 99%

Does White Coat Hypertension Require Treatment Over Age 80?

et al. 2013

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A ccurate measurement of blood pressure (BP) is an essential feature of any trial aiming to determine the relationship between BP reduction and outcome. BP control was the source of a controversy surrounding the results of the Heart Outcomes Prevention Evaluation (HOPE) trial, which claimed additional benefits from the use of an angiotensin-converting enzyme inhibitor (ramipril) versus placebo, because the between-group difference in clinic BP (CBP) was only 3/2 mm Hg.1 The beneficial effect was estimated to be 3 times that expected for this small difference in BP, 2 however, the possibility of a greater difference in BP was suggested by a small substudy of HOPE that measured ambulatory BP (ABP) and found a between-group difference of 10/4 mm Hg. 3ABP does not exactly mirror CBP, even if a fixed correction factor is used and the timing of the CBP measurement during the day is taken into account, for example, by comparing morning ABP values with morning CBP. The difference between CBP and ABP also depends on the degree of the alarm response induced in the office and varies from person to person, method of measurement, and the observer. This office or alarm response tends to increase with age 4,5 and decrease with the familiarity with the measurement. Furthermore, the machine used to measure ABP or CBP may over-or underestimate BP. When CBP is above normal and ABP is judged to be normal, then white coat hypertension (WCH) is said to be present. Importantly, it has long been considered desirable to avoid pharmaceutical treatment in those with WCH, because it has been suggested that active treatment does not lower ABP in this condition and also does not reduce cardiovascular events. Abstract-White coat hypertension is considered to be a benign condition that does not require antihypertensive treatment.Ambulatory blood pressure (ABP) was measured in 284 participants in the Hypertension in the Very Elderly Trial (HYVET), a double-blind randomized trial of indapamide sustained release 1.5 mg±perindopril 2 to 4 mg versus matching placebo in hypertensive subjects (systolic blood pressure 160-199 mm Hg) aged >80 years. ABP recordings (Diasys Integra II) were obtained in 112 participants at baseline and 186 after an average follow-up of 13 months. At baseline, clinic blood pressure (CBP) exceeded the morning ABP by 32/10 mm Hg. Fifty percent of participants fulfilled the established criteria for white coat hypertension. The highest ABP readings were in the morning (average 140/80 mm Hg), the average night-time pressure was low at 124/72 mm Hg, and the average 24-hour blood pressure was 133/77 mm Hg. During follow-up, the systolic/diastolic blood pressure placebo-active differences averaged 6/5 mm Hg for morning ABP, 8/5 mm Hg for 24-hour ABP, and 13/5 mm Hg for CBP. The lowering of blood pressure over 24 hours supports the reduction in blood pressure with indapamide sustained release±perindopril as the explanation for the reduction in total mortality and cardiovascular events observed in the main HYVET study. Because we es...

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“…Misclassification of BP status can occur as many as one of three hypertensive subjects [17][18][19]. Figure 1 shows the four-group distribution of 34 563 hypertensive patients from the Spanish ABPM Registry according to office and 24-h ambulatory BP criteria.…”

Section: Methods Of the Spanish Abpm Registrymentioning

confidence: 99%

“…A series of analyses from the Spanish ABPM Registry have assessed prevalence of white-coat and masked hypertension in general treated hypertensives [17,19], untreated hypertensives [18], treated male vs. female hypertensives [20], hypertensives with coronary heart disease [21], very elderly hypertensives [22], resistant hypertensives [23], diabetics [24] and hypertensives with chronic kidney disease [25]. Prevalence of white-coat hypertension ranged from 15Á5% to 29Á2% in untreated patients, and prevalence of white-coat false resistance ranged from 24Á2% in treated males to 37Á5% in hypertensives resistant to three or more drugs.…”

Section: Prevalence Of White-coat and Masked Hypertensionmentioning

confidence: 99%

Ambulatory blood pressure monitoring in daily clinical practice – the Spanish ABPM Registry experience

Gorostidi

Banegas

Sierra

et al. 2015

Eur J Clin Investigation

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Many patients are hypertensive at the medical settings but show normal blood pressure out of the doctor's office, and are classified as white-coat hypertensives. On the other hand, many patients with controlled hypertension at the clinic show ambulatory blood pressure levels above the thresholds considered for an adequate blood pressure control, known as having masked hypertension. Using data from the Spanish Ambulatory Blood Pressure Monitoring Registry (Spanish ABPM Registry), a national program developed to promote the use of the ambulatory technique for hypertension management in daily practice, we have reviewed the main strengths of this approach, that is the ability to detect discrepancies of blood pressure status with respect to office blood pressure measurement, and to better assess accurate rates of hypertension control. White-coat hypertension within patients with elevated office blood pressure, and masked hypertension within office-controlled patients affected one of three patients in each office status. On the other hand, rates of ambulatory blood pressure control (50%) doubled those of office blood pressure control (25%), still remaining half the patients uncontrolled. We think that a systematic use of ambulatory blood pressure monitoring, and strategies to improve blood pressure control constitute key priorities in hypertension management. Keywords Ambulatory blood pressure measurement, blood pressure, blood pressure measurement, hypertension, masked hypertension, white-coat hypertension. Eur J Clin Invest 2016; 46 (1): 92-98

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Clinical characteristics of isolated clinic hypertension

Abstract: The prevalence of ICH is between 15 and 29%, depending on the defining criterion used. The 24-h ICH criteria are not affected by awake/sleep biases, and should be preferred. Clinical capacity for predicting ICH is low.

Cited by 52 publications

References 39 publications

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

Prevalence and Associated Factors of Silent Brain Infarcts in a Mediterranean Cohort of Hypertensives

Does White Coat Hypertension Require Treatment Over Age 80?

Ambulatory blood pressure monitoring in daily clinical practice – the Spanish ABPM Registry experience

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