title: Ambulatory blood pressure measurement in the main cities of Cameroon: prevalence of masked and white coat hypertension, and influence of body mass index.
abstract: BACKGROUND
  Identifying White Coat Hypertension (WCH) may avoid inappropriate commitment of individuals to lifelong and costly blood pressure (BP) lowering medications'. We assessed the prevalence and determinants of WCH in urban clinical settings in Cameroon.
  
  
  METHODS
  Participants were a consecutive sample of adults, who underwent ambulatory BP measurements (ABPM) for the diagnosis of hypertension and evaluation of treatmentin three referral cardiac clinics in the cities of Yaounde and Douala, between January 2006 and July 2011. WCH was defined as an office-based systolic (or diastolic) BP ≥ 140(90) mmHg together with an average day time ambulatory systolic (and diastolic) BP < 135(85) mmHg.
  
  
  RESULTS
  Of the 500 participants included, 188 (37.6%) were women, 230 (46%) were nonsmokers and 53 (10.6%) had diabetes mellitus. The mean age was 51.6±10.2 years. The ABPM readings were higher in men than in women (p<0.05).The prevalence of WCH was 26.4% overall, 39.3% in women and 22.4% in men (p=0.01).In multivariable analysis, body mass index was the only significant determinant of WCH (Odds ratio= 1.15(95% confidence intervals: 1.00-1.43), p<0.05).
  
  
  CONCLUSIONS
  The prevalence of WCH was high in our study population and was correlated only with BMI. Accurate measurement of BP and appropriate diagnosis of hypertension using ABPM in this setting may help limiting the consequences of over estimating hypertension severity on individuals, families and health systems.
authors.affiliation: Global Health Systems Solution, Limbe, Cameroon.
authors.forename: Noah
authors.initials: N
authors.lastname: Takah
authors.affiliation: Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon ; Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, South Africa ; Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.
authors.forename: Anastase
authors.initials: A
authors.lastname: Dzudie
authors.affiliation: Douala cardiovascular centre of Bonapriso, Douala, Cameroon.
authors.forename: Jules
authors.initials: J
authors.lastname: Ndjebet
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon.
authors.forename: Guela
authors.initials: G
authors.lastname: Wawo
authors.affiliation: Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.
authors.forename: Félicité
authors.initials: F
authors.lastname: Kamdem
authors.affiliation: Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.
authors.forename: Yves
authors.initials: Y
authors.lastname: Monkam
authors.affiliation: Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.
authors.forename: Henry
authors.initials: H
authors.lastname: Luma
authors.affiliation: Department of Internal Medicine, Yaoundé University Teaching Hospital Yaoundé, Cameroon.
authors.forename: Kathleen Blackett
authors.initials: KB
authors.lastname: Ngu
authors.affiliation: Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, South Africa ; South African Medical Research Council of South Africa, Cape Town South Africa Department of Medicine, University of Cape Town, Cape Town, South Africa ; Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
authors.forename: André Pascal
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014505:Urban Population; D059466:White Coat Hypertension / Q000453:epidemiology*
keywords: Ambulatory Blood Pressure Monitoring; White Coat Hypertension; determinants; diagnosis
references.citation: Prog Cardiovasc Dis. 2013 Nov-Dec;56(3):363-6
references.pmid: 24267444
references.citation: Am J Hypertens. 1996 Oct;9(10 Pt 1):943-52
references.pmid: 8896645
references.citation: J Hum Hypertens. 1996 Feb;10(2):87-92
references.pmid: 8867561
references.citation: J Hypertens. 1995 Dec;13(12 Pt 1):1377-90
references.pmid: 8866899
references.citation: Cardiovasc J S Afr. 2004 Jul-Aug;15(4):157-8
references.pmid: 15322570
references.citation: Blood Press Monit. 2003 Feb;8(1):37-40
references.pmid: 12604935
references.citation: Asia Pac J Clin Nutr. 2001;10(2):76-80
references.pmid: 11710361
references.citation: J Pak Med Assoc. 2011 Sep;61(9):938-43
references.pmid: 22360048
references.citation: J Hypertens. 2011 Jul;29(7):1243-52
references.pmid: 21540748
references.citation: Int J Clin Pharm. 2011 Jun;33(3):582-9
references.pmid: 21523351
references.citation: BMJ. 2010;340:c1104
references.pmid: 20392760
references.citation: Korean J Intern Med. 2007 Dec;22(4):256-62
references.pmid: 18309684
references.citation: East Mediterr Health J. 2009 Mar-Apr;15(2):400-7
references.pmid: 19554987
references.citation: Blood Press Monit. 2007 Apr;12(2):95-9
references.pmid: 17353652
references.citation: Am J Hypertens. 2005 May;18(5 Pt 1):589-93
references.pmid: 15882539
references.citation: Heart. 2013 Oct;99(19):1390-7
references.pmid: 23708775
references.citation: Blood Press Monit. 2004 Dec;9(6):307-9
references.pmid: 15564985
references.citation: Lancet. 2005 Jan 15-21;365(9455):217-23
references.pmid: 15652604