Ambulatory blood pressure measurement in the main cities of Cameroon: prevalence of masked and white coat hypertension, and influence of body mass index

Abstract

INTRODUCTION:in this study, we have to identify White Coat Hypertension (WCH) may avoid inappropriate commitment of individuals to lifelong and costly blood pressure (BP) lowering medications. We assessed the prevalence and determinants of WCH in urban clinical settings in Cameroon. METHODS: participants were a consecutive sample of adults, who underwent ambulatory BP measurements (ABPM) for the diagnosis of hypertension and evaluation of treatmentin three referral cardiac clinics in the cities of Yaounde and Douala, between January 2006 and July 2011. WCH was defined as an office-based systolic (or diastolic) BP e" 140(90) mmHg together with an average day time ambulatory systolic (and diastolic) BP less than 135(85) mmHg. RESULTS: of the 500 participantsincluded, 188 (37.6%) were women, 230 (46%) were nonsmokers and 53 (10.6%) had diabetes mellitus. The mean age was 51.6,10.2years. The ABPM readings were higher in men than in women (p=0.05).The prevalence of WCH was 26.4% overall, 39.3% in women and22.4% in men (p=0.01).In multivariable analysis, body mass index was the only significant determinant of WCH (Odds ratio= 1.15(95% confidence intervals: 1.00-1.43), p=0.05). CONCLUSION: the prevalence of WCH was high in our study population and was correlated only with BMI. Accurate measurement of BP and appropriate diagnosis of hypertension using ABP Min this setting may help limiting the consequences of over estimating hypertension severity on individuals, families and health systems.

Keywords

• white coat hypertension
• determinants
• diagnosis
• ambulatory blood pressure monitoring