Prevalence and determinants of isolated clinic hypertension in the Finnish population: the Finn-HOME study

BACKGROUND: Previous studies performed in selected hypertensive subjects have reported several possible determinants of isolated clinic hypertension (ICH). The purpose of this study was to assess the prevalence and determinants of ICH in a randomly selected nationwide population. METHODS: We studied a representative sample of the general adult population (1440 45-74-year-old subjects) in Finland not treated for hypertension. The subjects were drawn from the participants of a multidisciplinary epidemiological survey, the Health 2000 Study. Subjects included in the study underwent a clinical interview, determination of serum lipids and glucose, measurement of clinic and home blood pressure (BP), and psychometric tests for psychological distress, hypochondriasis, depression, and alexithymia. The diagnosis of ICH was based on a clinic BP of 140/90 mmHg or greater and a home BP less than 135/85 mmHg. RESULTS: The prevalence of ICH in the untreated Finnish adult population was 15.6 and 37.5% among untreated clinic hypertensive individuals. In a multivariate logistic regression analysis, ICH was associated with mildly elevated systolic and diastolic BP, lower body mass index (BMI), and non-smoking status. Subjects with ICH represent an intermediate group between the normotensive and sustained hypertensive individuals where cardiovascular risk is concerned (age, BP, diabetes prevalence, lipid profile, and BMI). CONCLUSION: ICH is a common phenomenon in the general population. Non-smoking individuals with mildly elevated BP and low BMI have a higher risk of ICH. Physicians should disassociate the diagnosis of ICH from any psychosocial disorders, but should remember that patients with ICH have an increased risk of cardiovascular disease.