Korean J Intern Med.  2007 Dec;22(4):256-262. 10.3904/kjim.2007.22.4.256.

Prevalence, Predictive Factor, and Clinical Significance of White-Coat Hypertension and Masked Hypertension in Korean Hypertensive patients

• Hwang ES
• Choi KJ
• Kang DH
• Nam GB
• Jang JS
• Jeong YH
• Lee CH
• Lee JY
• Park HK
• Park CH

• KMID: 1776677
• DOI: http://doi.org/10.3904/kjim.2007.22.4.256

Abstract

BACKGROUND: The prevalence and clinical significance of white-coat hypertension (WCHT) and masked hypertension (MHT) are unknown in Koreans. Here we measure the frequency of WCHT and MHT in hypertensive subjects and identify the epidemiologic and/or clinical factors that predict it in Korean subjects. METHDOS: This study is a retrospective analysis of a random sample from February 2004 to October 2005. All patients had measurements of blood pressure (BP) in the clinic and 24-hour ambulatory blood pressure monitoring (ABPM). Subjects were classified into four groups on the basis of daytime ambulatory BP and clinic BP level: 1) Normotension (NT), 2) MHT, 3) WCHT, and 4) sustained hypertension (SHT). RESULTS: For all 967 patients, the mean clinic BP was 157.7+/-22.0/ 95.3+/-13.1 mmHg, and the mean daytime ambulatory BP was 136.4+/-15.0/ 86.2+/-10.7 mmHg. The NT, MHT, WCHT, and SHT groups consisted of 51 (5.3%), 55 (5.7%), 273 (28.2%), and 588 (60.8%) subjects, respectively. The left ventricular mass index was significantly higher in SHT than in the other groups, and was positively correlated with BP, especially ABPM. Compared with NT, the factors associated with MHT were younger age, male gender, higher BMI, clinic BP > or =130 mmHg, and alcohol consumption. Compared with SHT, the factors associated with WCHT were female gender, lower BMI, and clinic BP < 150 mmHg. CONCLUSIONS: WCHT and MHT were prevalent in the hypertensive population. ABPM was more predictive of target organ damage than clinic BP, and could be useful in identifying subjects at risk for WCHT and MHT.

Keyword

White-coat hypertension; Masked hypertension; Ambulatory BP monitoring

MeSH Terms

Blood Pressure Monitoring, Ambulatory
Female
Health Status Indicators
Heart Ventricles/*physiopathology/ultrasonography
Humans
Hypertension/*epidemiology/ultrasonography
Hypertrophy, Left Ventricular/*physiopathology/ultrasonography
Korea/epidemiology
Male
Middle Aged
Prevalence
Retrospective Studies
Risk Factors