Myers M G, Reeves R A
Division of Cardiology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
J Hum Hypertens. 1995 Sep;9(9):729-33.
Ambulatory blood pressure recordings were performed in patients receiving anti-hypertensive therapy to determine the prevalence of a white coat effect and to evaluate the importance of the sex of the patients with higher office vs. ambulatory blood pressure (BP) readings. A white coat effect (office--ambulatory BP > or = 20/10 mm Hg) was present in 106 of 152 treated hypertensive patients who had a mean office BP (mm Hg) of 174 +/- 2/94 +/- 1 compared with a mean awake ambulatory BP of 137 +/- 2/81 +/- 1 (P < 0.001). A severe white coat effect (office--ambulatory BP > or = 40/20 mm Hg) was observed in 49 of 152 patients with office BP (183 +/- 3/96 +/- 2) being higher (P < 0.001) than mean awake ambulatory BP (134 +/- 2/77 +/- 1). A white coat effect was present in 70 of 87 women but only in 36 of 65 men (P < 0.001). Similarly, a severe white coat effect was seen in 41 of 87 women but only in 8 of 65 men (P < 0.001). Female sex and office SBP were significantly (P < 0.001) correlated with the presence of a white coat or severe white coat effect. Thus, female patients with treated hypertension are more likely than men to have a white coat component to their high office BP readings. These sex differences in white coat effect should be considered in future studies involving patients with hypertension based on high office readings.
对接受抗高血压治疗的患者进行动态血压记录，以确定白大衣效应的发生率，并评估诊室血压与动态血压读数较高的患者性别因素的重要性。152例接受治疗的高血压患者中，106例存在白大衣效应（诊室血压-动态血压≥20/10 mmHg），其平均诊室血压（mmHg）为174±2/94±1，而平均清醒时动态血压为137±2/81±1（P<0.001）。152例患者中，49例观察到严重白大衣效应（诊室血压-动态血压≥40/20 mmHg），其诊室血压（183±3/96±2）高于平均清醒时动态血压（134±2/77±1）（P<0.001）。87名女性中有70名存在白大衣效应，而65名男性中只有36名存在（P<0.001）。同样，87名女性中有41名观察到严重白大衣效应，而65名男性中只有8名（P<0.001）。女性性别和诊室收缩压与白大衣效应或严重白大衣效应的存在显著相关（P<0.001）。因此，接受治疗的高血压女性患者比男性更有可能在其较高的诊室血压读数中存在白大衣成分。在未来基于高诊室读数的高血压患者研究中，应考虑白大衣效应的这些性别差异。
