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Ambulatory Blood Pressure Monitoring to Assess the White-Coat Effect in an Elderly East African Population

Lookup NU author(s): Dr Matthew Dewhurst, Dr Felicity DewhurstORCiD, Professor Richard Walker

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Abstract

The authors hypothesized that published hypertension rates inTanzania were influenced by the physiological response ofindividuals to blood pressure (BP) testing, known as thewhite-coat effect (WCE). To test this, a representative sample of 79 participants from a baseline cohort of 2322 people aged 70years and older were followed to assess BP using conventional BP measurement (CBPM) and ambulatory BP monitoring (ABPM). There was a significant difference between daytime ABPM and CBPM for both systolic BP (mean difference 29.7mmHg) and diastolic BP (mean difference 7.4mmHg). Rates of hypertension were significantly lower when measured by 24-hour ABPM (55.7%) than by CBPM (78.4%). The WCE was observed in 54 participants (68.4%). The WCE was responsible for an increase in recorded BP. Accurate identification of individuals in need of antihypertensive medication is important if resources are to be used efficiently, especially in resource-poor settings.

Publication metadata

Author(s): Ivy A, Tam J, Dewhurst MJ, Gray WK, Chaote P, Rogathi J, Dewhurst F, Walker RW

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Hypertension

Year: 2015

Volume: 17

Issue: 5

Pages: 389-394

Print publication date: 01/05/2015

Online publication date: 18/02/2015

Acceptance date: 09/11/2014

ISSN (print): 1524-6175

ISSN (electronic): 1751-7176

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/jch.12501

DOI: 10.1111/jch.12501

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