Bhattarai M, Sainju N K, Bhandari B, Kc V, Karki D B
Department of Cardiology, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
Medical Education Department, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2019 Apr-Jun;17(66):119-122.
Background Hypertension is a major cardiovascular risk factor. White coat hypertension refers to elevated office blood pressure but normal out of office blood pressure. White-coat hypertension has a risk of cardiovascular events more than normotensives. Objective To identify the prevalence of white coat hypertension among patients presented in the cardiology department. Method The descriptive cross-sectional study was conducted among 165 patients who visited the cardiology outpatient department of Kathmandu Medical College and Teaching Hospital from December 2017 to November 2018. Blood pressure was measured at the hospital, and ambulatory blood pressure device was used to monitor 24hrs pattern. Hypertension is classified as per recent guideline. Data were entered and analysed using Statistical Package for social sciences version 20. Result Out of 165 ambulatory blood pressure monitoring conducted patients, 140 participants were enrolled in the study based on inclusion criteria. Among them 55% (77) were male, and 45% (63) were female. Age ranged from 18-78 years with a mean of 43.82 ± 12.31 years. Overall among 140 participants 14.28% had white coat hypertension, however, after excluding twenty-two high normal group, among 118 participants who were hypertensive according to office BP, 16.9% (20) had white coat hypertension, and 33.57% of patients did not have nocturnal dipping of blood pressure. Conclusion The white coat hypertension is prevalent among around one-sixth of hypertensive patients visiting tertiary care centre, and one third have non-dipping which needs to be considered in the management of hypertension.
高血压是主要的心血管危险因素。白大衣高血压是指诊室血压升高但诊室外血压正常。白大衣高血压患者发生心血管事件的风险高于血压正常者。目的：确定心内科就诊患者中白大衣高血压的患病率。方法：对2017年12月至2018年11月在加德满都医学院教学医院心内科门诊就诊的165例患者进行描述性横断面研究。在医院测量血压，并使用动态血压监测仪监测24小时血压变化模式。根据最新指南对高血压进行分类。使用社会科学统计软件包第20版录入和分析数据。结果：在165例行动态血压监测的患者中，根据纳入标准，140例参与者纳入研究。其中男性55%（77例），女性45%（63例）。年龄范围为18 - 78岁，平均年龄为43.82±12.31岁。在140例参与者中，总体有14.28%患有白大衣高血压，然而，排除22例高正常血压组后，在根据诊室血压诊断为高血压的118例参与者中，16.9%（20例）患有白大衣高血压，33.57%的患者不存在血压夜间下降情况。结论：在三级医疗中心就诊的高血压患者中，约六分之一患有白大衣高血压，三分之一存在血压非勺型变化，这在高血压管理中需要予以考虑。
