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High BP might just be doc-induced 'white coat' hypertension


March 29, 2011 - Washington

One-third of patients thought to have resistant high Blood Pressure may actually have 'white coat' hypertension, according to a new study.

White coat hypertension is when a patient's Blood Pressure is high at the doctor's office but normal in everyday life.

Resistant hypertension occurs when a patient's Blood Pressure remains above treatment goals, despite taking three different types of drugs at the same time.

In this study, Spanish researchers used 24-hour ambulatory monitoring to check the Blood Pressure of 69,045 patients with an average age 64 and diagnosed with hypertension.

The ambulatory monitoring involved regular Blood Pressure checks every 20 minutes under normal living and working conditions.

The researchers found that 37 percent of the 8,295 patients diagnosed with resistant hypertension actually had white coat hypertension, and that more women than men had white coat hypertension - 42 percent versus 34 percent.

They also found that patients with true resistant hypertension were slightly younger, more often male, had a longer duration of hypertension and a worse cardiovascular risk profile.

This group included a higher number of smokers, diabetics and patients with ventricular hypertrophy and previous cardiovascular disease.

Close to 63 percent had true resistant hypertension.

"Ambulatory monitoring showed that many of these patients' Blood Pressures were in the normal range when they were at home or participating in their usual activities," said Alejandro de la Sierra, lead author of the study and director of internal medicine at Hospital Mutua Terrassa, University of Barcelona in Spain.

"Ambulatory Blood Pressure monitoring should be mandatory in resistant hypertension patients to define true and 'white coat' hypertension," he said.

"Patients benefit by knowing whether their Blood Pressure is normal during daily activities or still needs the reinforcement of dietary and drug measures to achieve the goal," he added.

The findings appear in the journal Hypertension.

ANI

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