Hanes DS, Dharia AG, Ladeji O, Hooper FL, Keys I, Weir MR
Demographic variables associated with diurnal blood pressure
variations in essential and white coat hypertensives
11th Scientific Meeting, American Society of Hypertension
Am J Hypert
(Apr) 9:118A 1996
Normotensives and most essential hypertensives display the so
called dipping pattern of blood pressure during sleep. Having a
dipping pattern is generally considered favorable although excessive
dipping may also be hazardous. For example hypertensive subjects with
peristently elevated nocturnal BP tend to have larger left ventricular
mass and also are at added risk for stroke. However, recently concern
has been raised that excess lowering at night may itself cause
ischemic cerebral lesions.
These authors examined the dipping pattern of subjects with so-called
white-coat hypertension (WCH, not defined). They studied a group of
hypertensive subjects (54) and white-coat hypertensives (105) with
multiple regression analysis to examine the degree of night time dip
in diastolic BP. They found that about 15% of the WCH did not show a
decline in diastolic BP and suggested that this may render these
patients at added cardiovascular risk. They also found, that the a
lack of BP decline at night was correlated to mean BP as well as
daytime diastolic BP.
Comment: The main limitations of this data involve the absent
definition of
WCH, lack of information regarding drug therapy, and lack in their
analysis of the systolic BP. Despite this, it is reassuring that such
a small percentage of the patients with WCH were nondippers. A control
group of normotensives would also have been useful.
(George Mansoor, M.D., University of Connecticut)
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11th Scientific Meeting, American Society of Hypertension
H: Exam and lab tests :
Ambulatory monitoring
H: Exam and lab tests :
White coat hypertension