title: Cardiovascular risk in white coat hypertension: an evaluation of the ankle brachial index.
abstract: The aim in this study was to identify the cardiovascular risk in patients suffering from white coat hypertension (WCH) by determining the ankle brachial index (ABI) with an automatic oscillometric sphygmomanometer. The study was undertaken in a Brazilian city between August 2010 and June 2011. The study variables were age, ethnic origin, marital status, education level, profession, weight, height, waist circumference, arm and ankle blood pressure (BP), and ABI. Analysis of variance was used for repeated measures and Tukey's test for multiple comparisons of means. The linear relationship between systolic BP levels and ankle brachial indices was verified using Pearson's correlation coefficient. Results were expressed as mean values ± standard errors of means, and differences were considered statistically significant when P < .05. Study participants were 135 subjects, including 37% normotensive, 37% hypertensive (HT), and 26% WCH patients. WCH individuals revealed intermediate risk in the analysis of the clinical variables. Alterations compatible with peripheral obstructive arterial disease and arterial calcification were observed only in the HT and WCH groups. These findings lead to the premise that WCH should not be viewed as a benign condition. The measurement of the ABI should be considered in the clinical approach of patients and professionals should use it as an instrument for cardiovascular risk assessment in routine health care delivery.
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil. Electronic address: dayana_df@hotmail.com.
authors.forename: Dayana
authors.initials: D
authors.lastname: Freitas
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
authors.forename: Adrielle Naiara
authors.initials: AN
authors.lastname: Toneti
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
authors.forename: Evandro José
authors.initials: EJ
authors.lastname: Cesarino
authors.affiliation: Sermed Saúde SA, São Paulo, Brazil.
authors.forename: Vagner Luis
authors.initials: VL
authors.lastname: Desidério
authors.affiliation: Sermed Saúde SA, São Paulo, Brazil.
authors.forename: Sérgio de Figueiredo
authors.initials: Sde F
authors.lastname: Pacca
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
authors.forename: Simone de
authors.initials: Sd
authors.lastname: Godoy
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
authors.forename: Isabel Amélia Costa
authors.initials: IA
authors.lastname: Mendes
authors.affiliation: University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
authors.forename: Leila Maria
authors.initials: LM
authors.lastname: Marchi-Alves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index / Q000451:nursing*; D001795:Blood Pressure Determination / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D059466:White Coat Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing*