Association between white-coat effect and blunted dipping of nocturnal blood pressure.

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State: Public
Version: author
Serval ID
serval:BIB_986B38CD8370
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association between white-coat effect and blunted dipping of nocturnal blood pressure.
Journal
American journal of hypertension
Author(s)
Bochud M., Bovet P., Vollenweider P., Maillard M., Paccaud F., Wandeler G., Gabriel A., Burnier M.
ISSN
1941-7225 (Electronic)
ISSN-L
0895-7061
Publication state
Published
Issued date
10/2009
Peer-reviewed
Oui
Volume
22
Number
10
Pages
1054-1061
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
In this study, we assessed whether the white-coat effect (difference between office and daytime blood pressure (BP)) is associated with nondipping (absence of BP decrease at night).
Data were available in 371 individuals of African descent from 74 families selected from a population-based hypertension register in the Seychelles Islands and in 295 Caucasian individuals randomly selected from a population-based study in Switzerland. We used standard multiple linear regression in the Swiss data and generalized estimating equations to account for familial correlations in the Seychelles data.
The prevalence of systolic and diastolic nondipping (<10% nocturnal BP decrease) and white-coat hypertension (WCH) was respectively 51, 46, and 4% in blacks and 33, 37, and 7% in whites. When white coat effect and nocturnal dipping were taken as continuous variables (mm Hg), systolic (SBP) and diastolic BP (DBP) dipping were associated inversely and independently with white-coat effect (P < 0.05) in both populations. Analogously, the difference between office and daytime heart rate was inversely associated with the difference between daytime and night-time heart rate in the two populations. These results did not change after adjustment for potential confounders.
The white-coat effect is associated with BP nondipping. The similar associations between office-daytime values and daytime-night-time values for both BP and heart rate suggest that the sympathetic nervous system might play a role. Our findings also further stress the interest, for clinicians, of assessing the presence of a white-coat effect as a means to further identify patients at increased cardiovascular risk and guide treatment accordingly.

Keywords
Adult, Anxiety/ethnology, Blood Pressure, Blood Pressure Determination, Creatinine/urine, European Continental Ancestry Group/ethnology, Female, Humans, Hypertension/ethnology, Hypertension/physiopathology, Hypertension/psychology, Male, Middle Aged, Periodicity, Potassium/urine, Seychelles/ethnology, Sodium/urine, Switzerland/ethnology
Pubmed
Web of science
Open Access
Yes
Create date
06/10/2009 9:34
Last modification date
20/08/2019 16:00
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