›› 2018, Vol. 38 ›› Issue (11): 1370-.doi: 10.3969/j.issn.1674-8115.2018.11.018

• Original article (Clinical research) • Previous Articles     Next Articles

Discussion on using ambulatory blood pressure monitoring in the diagnostic criteria of white coat and masked hypertension

HU Zhe1, CHEN Xin1, CHANG Gui-li1, LI Ming-chun1, CHEN Jing1, CHU Shao-li1, WANG Ji-guang1, 2   

  1. 1. Department of Hypertension, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China; 2. Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2018-11-28 Published:2018-12-15
  • Supported by:
    Key Specialty Project of Hypertension of Shanghai Jiading District Health and Family Planning Commission, JDYXZDZK-2; Clinical Science and Technology Innovation Project of Shanghai Hospital Development Center, SHDC12016232; Research Fund of Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, 2016GL04, 2017ZY11

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Abstract: Objective · To investigate different methods on the diagnosis of white coat and masked phenomena in ambulatory blood pressure monitoring (ABPM). Methods · Information of clinical characteristics and laboratory data were collected, and measurements of office blood pressure (OBP) and ambulatory blood pressure (ABP) in 274 subjects were performed, including 46 persons with high normal OBP (SBP/DBP 130-139/85-89 mmHg) (1 mmHg0.133 kPa), 187 untreated patients with grade 1 and grade 2 hypertension (SBP/DBP 140-179/90-109 mmHg), and 41 treated hypertensive patients. Differences of 95th and 5th percentile between OBP and daytime ABP, were respectively taken as the cutoff for the definition of white coat phenomenon and masked phenomenon. Results · If white coat and masked phenomenon were diagnosed according to the current hypertension guidelines, the prevalence of white coat phenomenon did not differ between untreated and treated hypertensive patients (11.2% vs 7.3%, P0.460). In the untreated group, the prevalence of white coat phenomenon was higher in grade 2 than in grade 1 hypertension (20.0% vs 8.5%, P0.033), whereas the prevalence of white coat hypertension did not differ (2.2% vs 7.0%, P0.230). The prevalence of masked hypertension was 73.9% in high normal blood pressure group. The prevalence of masked uncontrolled hypertension was 4.9%. If the difference of 95th percentile ( ≥20.50/20.50 mmHg) and 5th percentile (≤-18.67/-6.00 mmHg) between OBP and daytime ABP were, respectively, used as the cutoff for the definition of white coat and masked phenomenon, the prevalence of white coat phenomenon did not differ between treated and untreated groups (12.2% vs 9.1%，P0.543). In the untreated group, the prevalence of white coat phenomenon was higher in grade 2 than in grade 1 hypertension (24.4% vs 4.2%, P0.000). The prevalence of masked phenomenon did not differ between persons with high normal OBP (15.2%) and untreated (5.9%) as well as treated hypertensive patients (12.2%) (P>0.05). Conclusion · The percentile methods may be useful for the diagnosis of white coat and masked phenomena.

Key words: office blood pressure, ambulatory blood pressure, white coat hypertension, masked hypertension

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