Lack of association between body-mass index and white-coat hypertension among referred patients.
OBJECTIVE
The association between body-mass index and ambulatory blood pressure variables is not straightforward. Specifically, there are contradicting data regarding the correlation between obesity and white-coat hypertension. The aim of this report was to study the relationship between body-mass index and the white-coat effect, defined by ambulatory monitoring.


METHODS
A retrospective analysis of a prospectively collected ambulatory blood pressure monitoring laboratory database was performed. We analyzed 3928 unselected ambulatory monitoring sessions of nontreated (n=1654) and treated (n=2274) patients, for statistical associations between body-mass index and blood pressure variables. Body-mass index was categorized according to National Institutes of Health classification or quartiles.


RESULTS
Office and ambulatory blood pressure variables correlated with body-mass index in untreated patients. Unadjusted, the systolic white-coat effect did not differ by body-mass index category, whereas the diastolic effect was higher in obese patients. Adjustment for age, sex and office blood pressure revealed inverse associations of body-mass index category with the systolic white-coat effect, in both untreated and treated patients. When determined categorically, neither overweight/obese untreated or treated patients had increased prevalence of white-coat hypertension. Multivariate linear regression models confirmed the negative correlation between body-mass index and the systolic white-coat effect in untreated (beta=-0.24, P<0.0001) and treated (beta=-0.14, P<0.05) patients.


CONCLUSIONS
In patients referred for ambulatory blood pressure monitoring there was no association between body-mass index and white-coat hypertension.
Ben-Dov
Iddo Z
IZ
Nephrology and Hypertension Services, and Department of Internal Medicine, Mount-Scopus Campus, Hadassah, Hebrew University Medical Center, Jerusalem 91120, Israel. bendovi@md.huji.ac.il
Mekler
Judith
J
Ben-Arie
Liora
L
Bursztyn
Michael
M
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D010824:Physicians' Offices; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors
D000959:Antihypertensive Agents