title: The Utility of Ambulatory Blood Pressure Monitoring for Diagnosing White Coat Hypertension in Older Adults.
abstract: The beneficial effect of antihypertensive medication on reducing the risk of cardiovascular disease (CVD) events is supported by data from randomized controlled trials of older adults with hypertension. However, in clinical practice, overtreatment of hypertension in older adults may lead to side effects and an increased risk of falls. The diagnosis and treatment of hypertension is primarily based on blood pressure measurements obtained in the clinic setting. Ambulatory blood pressure monitoring (ABPM) complements clinic blood pressure by measuring blood pressure in the out-of-clinic setting. ABPM can be used to identify white coat hypertension, defined as elevated clinic blood pressure and non-elevated ambulatory blood pressure. White coat hypertension is common in older adults but does not appear to be associated with an increased risk of CVD events among this population. Herein, we review the current literature on ABPM in the diagnoses of white coat hypertension in older adults, including its potential role in preventing overtreatment.
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA. Kristi.Reynolds@kp.org.
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.affiliation: Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta VAMC, 1670 Clairmont Road (11B), Decatur, GA, 30033, USA. cbbowli@emory.edu.|Emory University, 1841 Clifton Road, Atlanta, GA, 30329, USA. cbbowli@emory.edu.
authors.forename: C Barrett
authors.initials: CB
authors.lastname: Bowling
authors.affiliation: Kaiser Permanente Los Angeles Medical Center, 4700 Sunset Blvd, Los Angeles, CA, 90027, USA. John.J.Sim@kp.org.
authors.forename: John J
authors.initials: JJ
authors.lastname: Sim
authors.affiliation: Columbia University Medical Center, 622 West 168th Street, PH 9-310, New York, NY, 10032, USA. ls3192@cumc.columbia.edu.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Sridharan
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA. Teresa.N.Harrison@kp.org.
authors.forename: Teresa N
authors.initials: TN
authors.lastname: Harrison
authors.affiliation: Columbia University Medical Center, 622 West 168th Street, PH 9-310, New York, NY, 10032, USA. ds2231@cumc.columbia.edu.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
mesh_terms: D000368:Aged; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000188:drug therapy; D006801:Humans; D012307:Risk Factors; D059466:White Coat Hypertension / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents
keywords: Aged; Ambulatory blood pressure; Elderly; Hypertension; White coat hypertension