| Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension: A Meta-Analysis Using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Population. | |
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MedLine Citation:
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PMID: 22252396 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (≥90 mm Hg) or by daytime ABP (≥85 mm Hg), a history of cardiovascular disease, and persons <18 years of age, the present analysis totaled 7295 persons, of whom 1593 had isolated systolic hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP ≥140/<90 mm Hg and ABP <135/<85 mm Hg) and subjects with normal BP (CBP <140/<90 mm Hg and ABP <135/<85 mm Hg) were at similar risk (adjusted hazard rate: 1.17 [95% CI: 0.87-1.57]; P=0.29). Furthermore, in treated subjects with isolated systolic hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79-1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43-2.79]; P<0.0001) and treated subjects with normal BP (adjusted hazard rate: 1.98 [95% CI: 1.49-2.62]; P<0.0001) were at higher risk as compared with untreated normotensive subjects. In conclusion, subjects with sustained hypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, "treated normalized hypertension." Therefore, one should be cautious in applying the term "white-coat hypertension" to persons receiving antihypertensive treatment. |
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Authors:
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Stanley S Franklin; Lutgarde Thijs; Tine W Hansen; Yan Li; José Boggia; Masahiro Kikuya; Kristina Björklund-Bodegård; Takayoshi Ohkubo; Jørgen Jeppesen; Christian Torp-Pedersen; Eamon Dolan; Tatiana Kuznetsova; Katarzyna Stolarz-Skrzypek; Valérie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Lars Lind; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Yutaka Imai; Jiguang Wang; Hans Ibsen; Eoin O'Brien; Jan A Staessen; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-17 |
Journal Detail:
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Title: Hypertension Volume: - ISSN: 1524-4563 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Heart Disease Prevention Program, Division of Cardiology, School of Medicine, University of California, Irvine, CA; Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Research for Prevention and Health, Copenhagen, Denmark; Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Ruijin Hospital, Shanghai Institute of Hypertenson, Shanghai Jiaotong University School of Medicine, Shanghai, China; Departamento de Fisiopatología and Centro de Nefrología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, Japan; Section of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Copenhagen University Hospital, Copenhagen, Denmark; Cambridge University Hospitals, Addenbrook's Hospital, Cambridge, United Kingdom; First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy; Institute of Internal Medicine, Novosibirsk, Russian Federation; Asociación Española Primera de Socorros Mutuos, Montevideo, Uruguay; Aarhus University and Division of Cardiology, Holbak Hospital, Holbak, Denmark; Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands. |
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