Vinyoles E, de la Figuera M
Area Básica de Salud La Mina, Unidad Docente de Medicina de Familia y Comunitaria, Barcelona.
Med Clin (Barc). 1995 Sep 16;105(8):287-91.
White coat hypertension (WCH) is a relatively prevalent clinical situation (around 20% of the hypertense population). The aim of this study was to analyze the clinical characteristics of these patients.
A descriptive transversal study was carried out in general medicine consultations in a unrandomized sample of hypertensive patients receiving pharmacologic treatment. Twenty-four hour ambulatory blood pressure monitorization (ABPM) (SpaceLabs 90202-90207) was performed following three resting blood pressure (BP) determinations carried out during the visit at 5-minute intervals by mercury sphigmomanometer. WCH was defined as: BP during the consultation > 140 mmHg (systolic) or > 90 mmHg (diastolic) with a mean daily blood pressure by ABPM < 140/< 90 mmHg.
One hundred sixty-four patients (53% males) with a mean age of 48 years (SD 15.8) and a mean time of high blood pressure of 36 months (SD 51.4) were studied. Seventy-one patients (43%) fulfilled WCH criteria. WCH was significantly associated with females (p < 0.01), hypercholesterolemia (p < 0.05), lower involvement of target organs (p < 0.05), greater nocturnal tolerance to ABPM (p < 0.05) and lower mean nocturnal blood pressure (p < 0.001).
The prevalence of white coat hypertension is elevated. Most of these patients are females, have fewer target organ lesions that the remaining hypertensive patients although dyslipemia is more frequently observed in these cases.
白大衣高血压(WCH)是一种相对常见的临床情况(约占高血压人群的20%)。本研究的目的是分析这些患者的临床特征。
对接受药物治疗的高血压患者的非随机样本进行普通内科门诊的描述性横断面研究。在就诊期间,每隔5分钟用汞柱式血压计进行三次静息血压(BP)测定后,进行24小时动态血压监测(ABPM)(太空实验室90202 - 90207型)。WCH定义为:就诊时血压>140 mmHg(收缩压)或>90 mmHg(舒张压),而ABPM测定的平均每日血压<140/<90 mmHg。
研究了164例患者(53%为男性),平均年龄48岁(标准差15.8),高血压平均病程36个月(标准差51.4)。71例患者(43%)符合WCH标准。WCH与女性(p < 0.01)、高胆固醇血症(p < 0.05)、靶器官受累程度较低(p < 0.05)、对ABPM的夜间耐受性较高(p < 0.05)以及夜间平均血压较低(p < 0.001)显著相关。
白大衣高血压的患病率较高。这些患者大多数为女性,与其他高血压患者相比,靶器官损害较少,尽管这些病例中血脂异常更为常见。