Determinants of white-coat syndrome assessed by ambulatory blood pressure or self-measured home blood pressure.
BACKGROUND
Gender, age, smoking, race, and body mass index have been reported to determine the ambulatory white-coat effect (WCE) and white-coat hypertension (WCH).


METHODS
Baseline conventional, day-time ambulatory and self-measured home blood pressure measurements from the THOP trial were used to study the effect of gender, age, body mass index, smoking habits and treatment status on the white-coat syndrome as assessed by ambulatory monitoring or self-measurement.


RESULTS
The mean systolic/diastolic WCE was 9.1/6.7 mmHg if based on ambulatory blood pressure and 12.2/8.7 mmHg if based on self-measured blood pressure. The ambulatory WCE was significantly higher in women, in older subjects (65+), in obese subjects, in non-smokers and in patients on antihypertensive drug treatment. The self-measured WCE was significantly higher in women and in non-smokers. Ambulatory WCH was present in 6.6% of the untreated patients and 14.2% had self-measured WCH. The proportion of ambulatory WCH was significantly higher in obese subjects; the proportion of self-measured WCH did not differ by gender, age, body mass index, or smoking habits.


CONCLUSIONS
The ambulatory white-coat syndrome was determined by gender, age, body mass index, smoking habits, and treatment status. The self-measured white-coat syndrome was greater than the ambulatory white-coat syndrome but depended less on the determinants under study.
Den Hond
Elly
E
Study Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, Katholieke Universiteit Leuven, Leuven, Belgium. elly.denhond@med.kuleuven.ac.be
Celis
Hilde
H
Vandenhoven
Guy
G
O'Brien
Eoin
E
Staessen
Jan A
JA
D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010824:Physicians' Offices; D012648:Self Care; D012737:Sex Factors; D012907:Smoking