Blood Pressure (May 2018)

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

  • Thiago Veiga Jardim,
  • Carolina de Souza Carneiro,
  • Polyana Morais,
  • Vanessa Roriz,
  • Karla Lorena Mendonça,
  • Flávia Miquetichuc Nascente,
  • Thaís Inácio Rolim Póvoa,
  • Weimar Kunz Sebba Barroso,
  • Ana Luiza Lima Sousa,
  • Paulo César Veiga Jardim

DOI
https://doi.org/10.1080/08037051.2017.1422388
Journal volume & issue
Vol. 27, no. 3
pp. 151 – 157

Abstract

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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.

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