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Blood Press. 2018 Jun;27(3):151-157. doi: 10.1080/08037051.2017.1422388. Epub 2018 Jan 5.

White-coat, masked and sustained hypertension detected by home blood pressure monitoring in adolescents: prevalence and associated factors.

Author information

1
a Hypertension League , Federal University of Goias , Goiânia , GO , Brazil.
2
b Division of Cardiovascular Medicine , Brigham & Women's Hospital , Boston , MA , USA.
3
c Harvard TH Chan School of Public Health - Department of Health Policy and Management , Center for Health Decision Science , Boston , MA , USA.
4
d School of Physical Education and Therapy (ESEFFEGO) , State University of Goiás (UEG) , Goiânia , GO , Brazil.

Abstract

PURPOSE:

Population-based studies estimating prevalence's of white-coat, masked and sustained hypertension in non-European adolescents are needed, particularly in developing countries. Aiming to determine these estimates and, additionally identify factors associated to these conditions this study was conducted.

MATERIALS AND METHODS:

Cross-sectional study with a representative sample of secondary school students from a Brazilian state capital. Office measurements were performed with validated semi-automatic devices. Home BP (blood pressure) monitoring protocol included two day-time and two evening-time measurements over 6 days. Adolescents' were classified as: normotensives (office and home BP <95th percentile); sustained hypertensives (office and home BP ≥95th percentile); white-coat hypertensives (office BP ≥95th percentile and home BP <95th percentile) and masked hypertensives (office BP <95th percentile and home BP ≥95th percentile). Logistic regression models were built to identify if sex, age, BMI and family history of HTN were independently associated with white-coat, masked and sustained hypertension.

RESULTS:

In a sample of 1024 adolescents, prevalence of white-coat, masked and sustained hypertension was 7.5%, 2.2% and 1.7%, respectively. Male sex was positively associated with white-coat hypertension (OR 2.68; 95%CI 1.58-4.54; p < 0.001). BMI was positively associated with both white-coat (OR 1.23; 95%CI 1.16-1.30; p < 0.001) and sustained hypertension (OR 1.19; 95%CI 1.11-1.29; p < 0.001). None of the independent variables were associated with masked hypertension in this population.

CONCLUSION:

The estimated prevalence of white-coat hypertension, masked and sustained hypertension in a population of non-European adolescents assessed by home BP monitoring was 7.5%, 2.2% and 1.7% respectively. Male sex was positively associated with white-coat hypertension in these adolescents while BMI was positively associated with both white-coat and sustained hypertension.

KEYWORDS:

Pediatric; blood pressure measurement/monitoring; diagnostic method; home blood pressure; masked hypertension; white-coat hypertension

PMID:
29302991
DOI:
10.1080/08037051.2017.1422388
[Indexed for MEDLINE]

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