| The importance of the clinical observer in the development of a white-coat effect in African-American patients with hypertension. | |
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MedLine Citation:
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PMID: 18496287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: As the office-awake blood pressure (BP) difference (white-coat effect) in African-Americans has not been evaluated, we studied the ethnicity, professional status (nurse versus doctor) and sex of the observer on the white-coat effect in African-American patients with hypertension. METHODS: Seated clinical BP measurements were obtained in random order by an African-American male research physician, a Caucasian male research physician, and a Caucasian female nurse who is of similar age and clinical experience. Within 1 week, ambulatory BP recordings were performed. RESULTS: A total of 65 African-American patients [54+/-13 years, 55% women, body mass index (BMI) 31+/-6 kg/m, 62% on drug therapy, 28% current smokers] participated in the study. Twenty-two percent had a systolic white-coat effect >20 mmHg and 49% had a diastolic white-coat effect >10 mmHg (average of all observers). Although there were no differences in the magnitude of the white-coat effect among the three study observers, the primary physician's diastolic white-coat effect was significantly greater than that of the African-American physician (14+/-12 vs. 9+/-12, P=0.05), but not the systolic white-coat effect (16+/-16 vs. 10+/-16 mmHg, P=0.09). BMI positively correlated with the systolic and diastolic white-coat effect (r=0.30, P=0.02 and r=0.41, P=0.0001), but this correlation was true only for female patients in multiple regression analyses. BMI significantly predicted the systolic (P=0.043) and diastolic (P=0.004) white-coat effects. CONCLUSION: A white-coat effect is relatively common in African-American patients with hypertension and is the largest when the observer is their usual doctor. The clinical observer's ethnicity or sex does not play an important role in generating a white-coat effect in African-American patients with hypertension. |
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Authors:
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Paul T Labinson; Sharon Giacco; Henry Gift; George A Mansoor; William B White |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Blood pressure monitoring Volume: 13 ISSN: 1359-5237 ISO Abbreviation: Blood Press Monit Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-22 Completed Date: 2008-08-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9606438 Medline TA: Blood Press Monit Country: England |
Other Details:
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Languages: eng Pagination: 139-42 Citation Subset: IM |
Affiliation:
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Section of Hypertension and Clinical Pharmacology, Center for Cardiology and Cardiovascular Biology, University of Connecticut School of Medicine, Farmington, Connecticut 06030-3949, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult African Americans* Aged Blood Pressure Determination Blood Pressure Monitoring, Ambulatory* Body Mass Index European Continental Ancestry Group Female Humans Hypertension / diagnosis*, ethnology* Male Middle Aged Physician-Patient Relations* Physicians Sex Factors |
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