| Prognosis of "masked" hypertension and "white-coat" hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. | |
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MedLine Citation:
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PMID: 16053966 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to investigate the prognosis in subjects with "white-coat" hypertension (WCHT) and "masked" hypertension (MHT), in which blood pressure (BP) is lower in clinical measurements than during ambulatory monitoring. BACKGROUND: The prognostic significance of WCHT remains controversial, and little is known about MHT. METHODS: We obtained 24-h ambulatory BP and "casual" BP (i.e., obtained in clinical scenarios) values from 1,332 subjects (872 women, 460 men) > or =40 years old in a representative sample of the general population of a Japanese community. Survival and stroke morbidity were then followed up for a mean duration of 10 years. RESULTS: Composite risk of cardiovascular mortality and stroke morbidity examined using a Cox proportional hazards regression model for subjects with WCHT (casual BP > or =140/90 mm Hg, daytime BP <135/85 mm Hg; relative hazards [RH])1.28; 95% confidence interval [CI] 0.76 to 2.14) was no different from risk for subjects with sustained normal BP (casual BP <140/90 mm Hg, daytime BP <135/85 mm Hg). However, risk was significantly higher for subjects with MHT (casual BP <140/90 mm Hg, daytime BP > or =135/85 mm Hg; RH 2.13; 95% CI 1.38 to 3.29) or sustained hypertension (casual BP > or =140/90 mm Hg, daytime BP > or =135/85 mm Hg; RH 2.26; 95% CI 1.49 to 3.41) than for subjects with sustained normal BP. Similar findings were observed for cardiovascular mortality and stroke morbidity among subgroups by gender, use of antihypertensive medication, and risk factor level (all p for heterogeneity >0.2). CONCLUSIONS: Conventional BP measurements may not identify some individuals at high or low risk, but these people may be identifiable by the use of ambulatory BP. |
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Authors:
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Takayoshi Ohkubo; Masahiro Kikuya; Hirohito Metoki; Kei Asayama; Taku Obara; Junichiro Hashimoto; Kazuhito Totsune; Haruhisa Hoshi; Hiroshi Satoh; Yutaka Imai |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 46 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-01 Completed Date: 2005-08-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 508-15 Citation Subset: AIM; IM |
Affiliation:
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Department of Planning for Drug Development and Clinical Evaluation, Sendai, Japan. tohkubo@mail.tains.tohoku.ac.jp |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anxiety
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complications Blood Pressure Determination / methods Blood Pressure Monitoring, Ambulatory / methods* Cohort Studies Confidence Intervals Female Humans Hypertension / diagnosis*, mortality, psychology* Japan Longitudinal Studies Male Physician-Patient Relations* Probability Prognosis Reproducibility of Results Risk Assessment Sensitivity and Specificity Severity of Illness Index Survival Analysis |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2005 Aug 2;46(3):516-7
[PMID:
16053967
]
J Am Coll Cardiol. 2006 May 16;47(10):2127; author reply 2127-8 [PMID: 16697339 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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