Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study

Alwan, Heba; Pruijm, Menno; Ponte, Belen; Ackermann, Daniel; Guessous, Idris; Ehret, Georg; Staessen, Jan A.; Asayama, Kei; Vuistiner, Philippe; Younes, Sandrine E.; Paccaud, Fred; Wuerzner, Grégoire; Péchère-Bertschi, Antoinette; Mohaupt, Markus; Vogt, Bruno; Martin, Yves; Burnier, Michel; Bochud, Murielle (2014). Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study. PLoS ONE, 9(3), e92522. Public Library of Science 10.1371/journal.pone.0092522

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Objective

We investigated factors associated with masked and white-coat hypertension in a Swiss population-based sample.
Methods

The Swiss Kidney Project on Genes in Hypertension is a family-based cross-sectional study. Office and 24-hour ambulatory blood pressure were measured using validated devices. Masked hypertension was defined as office blood pressure<140/90 mmHg and daytime ambulatory blood pressure≥135/85 mmHg. White-coat hypertension was defined as office blood pressure≥140/90 mmHg and daytime ambulatory blood pressure<135/85 mmHg. Mixed-effect logistic regression was used to examine the relationship of masked and white-coat hypertension with associated factors, while taking familial correlations into account. High-normal office blood pressure was defined as systolic/diastolic blood pressure within the 130–139/85–89 mmHg range.
Results

Among the 652 participants included in this analysis, 51% were female. Mean age (±SD) was 48 (±18) years. The proportion of participants with masked and white coat hypertension was respectively 15.8% and 2.6%. Masked hypertension was associated with age (odds ratio (OR) = 1.02, p = 0.012), high-normal office blood pressure (OR = 6.68, p<0.001), and obesity (OR = 3.63, p = 0.001). White-coat hypertension was significantly associated with age (OR = 1.07, p<0.001) but not with education, family history of hypertension, or physical activity.
Conclusions

Our findings suggest that physicians should consider ambulatory blood pressure monitoring for older individuals with high-normal office blood pressure and/or who are obese.

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