Xu Dengyue, Qiu Hengxia, Li Ze, Yan Peishi, Xu He, Gu Yu, Lin Hailong
Postgraduate College, China Medical University, 110122 Shenyang, Liaoning, China.
Department of Cardiology, Dalian Municiple Central Hospital, 116000 Dalian, Liaoning, China.
Rev Cardiovasc Med. 2022 Oct 25;23(11):359. doi: 10.31083/j.rcm2311359. eCollection 2022 Nov.
The white coat effect is observed in many patients with hypertension, but its mechanism is still unclear and anxiety is often thought to be a key point.
A total of 544 patients who met the inclusion criteria were recruited through outpatient clinics. Three months after systematic treatment, the office blood pressure and ambulatory blood pressure monitoring (ABPM) were examined. Patients who reached the ABPM standard were divided into white coat effect (n = 112) and control (n = 432) groups according to the results of the office blood pressure. The degree of anxiety in the two groups was evaluated using the Self-rating Anxiety Scale (SAS) and the Beck Anxiety Scale (BAI). Differences in anxiety, gender, age, number of antihypertensive drugs, cost per tablet and marital status were analyzed.
There was no significant difference in the degree of anxiety between the white coat and control groups, with mean SAS standard scores of 32.8 8.5 . 31.8 9.9, respectively ( = 0.170). Similarly, the mean BAI standard scores were 31.4 8.3 . 31.2 9.5, respectively ( = 0.119). Logistic regression analysis showed that the factors of female gender ( = -1.230, 0.001), old age ( = 0.216, 0.001), number of antihypertensive drugs ( = 1.957, 0.001), and cost per tablet ( = 1.340, 0.001) were significantly related to the white coat effect.
Anxiety was not necessary for the white coat effect in hypertension patients during treatment. Female gender, old age, number of antihypertensive drugs used and cost per tablet were related to the white coat effect in hypertension patients during treatment.
许多高血压患者存在白大衣效应，但其机制仍不清楚，焦虑常被认为是关键因素。
通过门诊招募了544名符合纳入标准的患者。系统治疗3个月后，检测诊室血压和动态血压监测（ABPM）。根据诊室血压结果，将达到ABPM标准的患者分为白大衣效应组（n = 112）和对照组（n = 432）。采用自评焦虑量表（SAS）和贝克焦虑量表（BAI）评估两组的焦虑程度。分析焦虑、性别、年龄、降压药物数量、每片药费用和婚姻状况的差异。
白大衣效应组和对照组的焦虑程度无显著差异，SAS标准平均分分别为32.8±8.5和31.8±9.9（P = 0.170）。同样，BAI标准平均分分别为31.4±8.3和31.2±9.5（P = 0.119）。Logistic回归分析显示，女性（P = -1.230，P<0.001）、老年（P = 0.216，P<0.001）、降压药物数量（P = 1.957，P<0.001）和每片药费用（P = 1.340，P<0.001）与白大衣效应显著相关。
治疗期间高血压患者的白大衣效应并非由焦虑引起。女性、老年、所用降压药物数量和每片药费用与治疗期间高血压患者的白大衣效应有关。
