Open AccessThe importance of using 24‐hour and nighttime blood pressure for the identification of white coat hypertension: Data from the Jackson Heart Study
Author(s) -
Anstey D. Edmund,
Colantonio Lisandro D.,
Yano Yuichiro,
Booth John N.,
Muntner Paul
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13330
Subject(s) - daytime , medicine , blood pressure , white coat hypertension , diastole , cardiology , body mass index , ambulatory blood pressure , atmospheric sciences , geology
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/m 2 ), 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/m 2 , respectively). Using only daytime BP overestimates the prevalence of WCH among African Americans.