The importance of using 24‐hour and nighttime blood pressure for the identification of white coat hypertension: Data from the Jackson Heart Study |
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| Authors: | D Edmund Anstey MD MPH Lisandro D Colantonio MD PhD Yuichiro Yano MD PhD John N Booth PhD III Paul Muntner PhD |
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| Institution: | 1. Columbia University Irving Medical Center, New York, NY, USA;2. University of Alabama at Birmingham, Birmingham, AL, USA;3. University of Mississippi Medical Center, Jackson, MS, USA |
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| Abstract: | We calculated the prevalence of white coat hypertension (WCH) using out‐of‐clinic blood pressure (BP) in the daytime period; daytime and 24‐hour periods; and daytime, 24‐hour, and nighttime periods among 199 African Americans with clinic‐measured systolic/diastolic BP ≥140/90 mm Hg in the Jackson Heart Study. Left ventricular mass index (LVMI) was measured among participants with WCH and 374 participants with sustained normotension (ie, non‐hypertensive clinic, daytime, 24‐hour, and nighttime BP). The prevalence of WCH was 29.6%, 21.1%, and 10.6% using daytime BP; daytime and 24‐hour BP; and daytime, 24‐hour, and nighttime BP, respectively. Compared with sustained normotension, LVMI was higher when WCH was defined using daytime BP (adjusted mean difference 95% CI] 5.0 ?0.2, 10.1] g/m2), but not when defined using daytime and 24‐hour BP or daytime, 24‐hour, and nighttime BP (adjusted mean difference 95% CI] 3.9 ?1.9, 9.7] and 0.4 ?7.3,8.2] g/m2, respectively). Using only daytime BP overestimates the prevalence of WCH among African Americans. |
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| Keywords: | ambulatory blood pressure/home blood pressure monitor clinical management of high blood pressure (HBP) hypertension in African Americans hypertension— general risk assessment |
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