Document Detail

Factors influencing white-coat effect.
MedLine Citation:
PMID:  18174883     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The transient blood pressure (BP) rise during clinical visits is usually referred to as white-coat effect (WCE). The aim of the present study was to investigate factors that may influence the WCE. METHODS: A total of 2004 subjects underwent office BP measurements and 24-h ambulatory BP monitoring (ABPM) on the same day. The WCE was estimated as the difference between office and average daytime ambulatory BP (ABP). According to the office and daytime BP values, the study population was divided into normotensives (NTs), white-coat hypertensives (WCHs), masked hypertensives (MHTs), and sustained hypertensives (SHTs). Statistical analyses were performed using one-way analysis of variance and multiple linear regression models. RESULTS: The mean systolic and diastolic WCE was 9 +/- 16 and 7 +/- 12 mm Hg, respectively. In the entire group of patients, multiple linear regression models revealed independent determinants of systolic WCE in the following rank order: office systolic BP (SBP) (beta = 0.727; P < 0.001), female gender (beta = 0.166; P < 0.001), daytime SBP variability (beta = 0.128; P < 0.001), age (beta = 0.039, P = 0.020), and smoking (beta = 0.031, P = 0.048). A 1.0 mm Hg increase in daytime SBP variability correlated with an increment of 0.589 mm Hg (95% confidence intervals, 0.437-0.741) in the systolic WCE. The regression analyses for diastolic WCE revealed the same factors as independent determinants. A 1.0 mm Hg increase in daytime diastolic BP (DBP) variability was independently associated with an increment of 0.418 mm Hg (95% confidence intervals, 0.121-0.715) in the diastolic WCE. CONCLUSIONS: Factors such as gender, age, smoking, office BPV and daytime BPV may exert an important influence on the magnitude of the WCE.
Efstathios D Manios; Eleni A Koroboki; Georgios K Tsivgoulis; Konstantinos M Spengos; Ioanna K Spiliopoulou; Fiona G Brodie; Konstantinos N Vemmos; Nikolaos A Zakopoulos
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Publication Detail:
Type:  Journal Article     Date:  2008-01-03
Journal Detail:
Title:  American journal of hypertension     Volume:  21     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-04-24     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-8     Citation Subset:  IM    
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Athens, Greece.
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MeSH Terms
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology*
Hypertension / epidemiology*,  physiopathology*
Linear Models
Middle Aged
Multivariate Analysis
Physicians' Offices / statistics & numerical data*
Risk Factors
Sex Distribution
Smoking / epidemiology
Comment In:
Am J Hypertens. 2008 Feb;21(2):135   [PMID:  18268486 ]

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