三级医疗中心新诊断高血压患者的白大衣高血压及其预测因素

White Coat Hypertension and Its Predictors in Newly Diagnosed Hypertensive Patients Attending a Tertiary Care Center.

作者信息

Naik Muzafar, Altaf Junaid, Bhat Tariq, Tariq Azra, Mushtaq Khalid

机构信息

Associate Professor, Department of General Medicine, SKIMS Medical College & Hospital, Srinagar, Jammu and Kashmir, India, Orcid: https://orcid.org/0000-0003-2827-7987.

Senior Resident, Department of General Medicine, SKIMS Medical College & Hospital, Srinagar, Jammu and Kashmir, India.

出版信息

J Assoc Physicians India. 2025 Jul;73(7):25-28. doi: 10.59556/japi.73.1037.

DOI:10.59556/japi.73.1037

PMID:40836717

Abstract

BACKGROUND

The diagnosis of hypertension (HTN) is best achieved by ambulatory blood pressure monitoring (ABPM) as it helps differentiate sustained hypertension (SH) from white coat hypertension (WCH).

AIM

To diagnose SH and WCH in newly diagnosed hypertensive patients.

MATERIALS

All newly diagnosed hypertensive patients with office blood pressure measurement (OBPM) ≥140/90 mm Hg, attending the medical outpatient department and not on any antihypertensive treatment, were included in the study.

OBJECTIVES

To evaluate the clinical utility of ABPM in newly diagnosed hypertensive subjects by comparing OBPM with ABPM readings.

METHODS

This descriptive cross-sectional study was carried out on 196 newly diagnosed HTN patients over a period of 18 months. All hypertensive patients were subjected to ABPM. Patients with persistent HTN on ABPM were labeled as SH, whereas those with normal blood pressure on ABPM were labeled as WCH.

RESULTS

SH was diagnosed in 143 out of 196 (73%) patients. WCH was detected in 53 patients (27%). Patients with SH had a significant family history of HTN compared to patients with WCH (82.5 vs 45.3%, = 0.00), higher office diastolic blood pressure (DBP) compared to WCH (96.56 ± 4.63 vs 94.13 ± 3.23, = 0.000), and significant nondipping pattern compared to WCH (37.1 vs 18.9%, = 0.015).

CONCLUSION

ABPM should be performed in all newly diagnosed hypertensive patients, especially if they have no family history of HTN and DBP is <95 mm Hg, to rule out WCH.

摘要

背景

动态血压监测（ABPM）有助于区分持续性高血压（SH）和白大衣高血压（WCH），是诊断高血压（HTN）的最佳方法。

目的

诊断新诊断高血压患者的SH和WCH。

材料

纳入所有新诊断的高血压患者，这些患者在门诊测量的诊室血压（OBPM）≥140/90 mmHg，且未接受任何抗高血压治疗。

目标

通过比较OBPM和ABPM读数，评估ABPM在新诊断高血压患者中的临床应用价值。

方法

在18个月的时间里，对196例新诊断的高血压患者进行了这项描述性横断面研究。所有高血压患者均接受ABPM检查。ABPM显示持续性高血压的患者被标记为SH，而ABPM血压正常的患者被标记为WCH。

结果

196例患者中有143例（73%）被诊断为SH。53例患者（27%）被检测出患有WCH。与WCH患者相比，SH患者有显著的高血压家族史（82.5%对45.3%，P = 0.00），诊室舒张压（DBP）高于WCH患者（96.56±4.63对94.13±3.23，P = 0.000），且与WCH患者相比有显著的非勺型血压模式（37.1%对18.9%，P = 0.015）。