[Evolution of white coat hypertension to sustained hypertension. One year follow-up by ambulatory blood pressure monitoring].
BACKGROUND
To analyse the evolution of the white coat hypertension (WCH) to sustained hypertension, by means of ambulatory blood pressure monitoring (ABPM) during the first year after its diagnosis.


METHODS
A prospective study of cohorts was designed in La Orden Health Center of Huelva, Spain. 86 individuals divided in two groups: a) group not exposed (GNE): 43 voluntary normotensives, and b) group exposed (GE): 43 individuals with WCH, defined as the blood pressure was superior or above 140 and/or 90 mmHg, respectively, with a mean diurnal ABPM below 135 and 85 mmHg in both cases. A ABPM was performed (Spacelabs 90207) at the beginning of the study, after 6 months and after 12 months. The clinical and ambulatory blood pressure and the incidence of sustained hypertension by ABPM in the two groups were compared. Sustained hypertension was considered when the diurnal blood pressure was superior to 135 and/or 85 mmHg for SBP and DBP.


RESULTS
At the end of the study, 82 patients were evaluate. The incidence of hypertension at 6 months of follow-up was of 4,76% (CI, 0-26.9) in GNE and 19.04% (95% CI, 0-42,6) in GE (RR: 3.8; 95% CI, 0.86-16.9) (p = 0.052). At one year of follow-up the incidence of hypertension in GNE was of 9.8% (95% CI, 0.31-1) as opposed to 46.3% (95% CI, 20.5-72.1) in GE (RR: 4.63; CI, 1.7-12.4) (p = 0.001).


CONCLUSIONS
The patients with WCH present a higher incidence of hypertension as compared to the normotensives, after 12 months of our follow-up.
Márquez Contreras
E
E
Médicos especialistas en Medicina Familiar y Comunitaria. Centro de Salud La Orden. Huelva. emarquezc@papps.org
Joaquín Casado Martínez
J
J
Fernández Ortega
A
A
Javier Márquez Cabeza
J
J
D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies