Relationship between white-coat hypertension and office isolated systolic or diastolic hypertension: an ambulatory blood pressure monitoring study

Abstract

This study investigated the prevalence of white-coat hypertension (WCH) among individuals with office isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). We evaluated 9122 individuals [57.0 ± 14.5 years, 51% men] with office blood pressure ≥140/90 mmHg who underwent ambulatory blood pressure monitoring (ABPM) and were categorized into younger (<40-years), middle-aged (≥40 and <60-years) and older (≥60-years) groups. The prevalence of WCH in SDH, ISH, and IDH was 18, 61, and 37% in younger, 16, 55, and 29% in middle-aged, and 23, 51, and 40% in older individuals. Multivariable logistic regression analysis showed a higher likelihood of WCH in ISH (4.1, 3.6, and 2.1-fold all p < 0.001) and IDH (1.9, 1.5, and 1.5-fold; all p < 0.001) compared to SDH among younger, middle-aged and older individuals, respectively. These data indicate that ISH and, to a minor extent, IDH are linked to a higher prevalence of WCH derived from ABPM exams.

Keywords: Ambulatory blood pressure; Isolated diastolic hypertension; Isolated systolic hypertension; White-coat hypertension.