What does this research mean for the field?

A white coat effect is frequently present in treated hypertensive patients during routine clinical practice by family physicians, and these routine readings correlate poorly with ambulatory blood pressure and left ventricular mass index compared to special or nurse-administered readings. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to determine the prevalence of the white coat effect among treated hypertensive patients in the community.

June 1, 1995American Journal of Hypertension

Prevalence of white coat effect in treated hypertensive patients in the community

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Why the study?

Does the method of blood pressure measurement (routine physician vs special physician vs nurse) affect the prevalence of the white coat effect in treated hypertensive patients?

Key Points

This study aims to determine the prevalence of the white coat effect among treated hypertensive patients in the community.
Unselected population of 147 hypertensive patients treated by family physicians was studied.
Routine blood pressure readings were compared to special readings taken by physicians and readings taken by research nurses.
Correlations between different blood pressure readings and left ventricular mass index were analyzed.
White coat effect prevalence was 91/147 based on routine physician readings, while it was 54/147 for special physician readings and 30/147 for research nurse readings (P < .001).
Higher correlation was identified between ambulatory systolic blood pressure and research nurse readings (r = 0.62) or special physician readings (r = 0.55) compared to routine physician readings (r = 0.34).
Left ventricular mass index showed significant correlation with special physician (r = 0.27) and research nurse readings (r = 0.23), but not with routine physician readings (r = 0.06).

Structured PICO

Does the method of blood pressure measurement (routine physician vs special physician vs nurse) affect the prevalence of the white coat effect in treated hypertensive patients?

Population

147 hypertensive patients receiving treatment from their family physicians in the community

Intervention

Routine blood pressure readings by family physician

Comparator

Special blood pressure readings taken by the family physician for the study, or readings taken by a research nurse

Outcome

Prevalence of white coat effect (defined as office - ambulatory blood pressure ≥ 20/10 mm Hg)surrogate

Routine clinical blood pressure measurements by family physicians frequently overestimate true blood pressure, leading to a high prevalence of the white coat effect compared to standardized or ambulatory measurements.

Discussion

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Implication

Routine physician BP readings were associated with higher white coat effect; leaves open optimal measurement protocols for treated hypertension.

Cite This Study

Myers et al. (1995) studied this question.

synapsesocial.com/papers/6a19d9563e4c9aaeb7f670d2 https://doi.org/10.1016/0895-7061(95)00049-u

Topics

Hypertension management Echocardiography

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Implication

Routine physician BP readings were associated with higher white coat effect; leaves open optimal measurement protocols for treated hypertension.

Prevalence of white coat effect in treated hypertensive patients in the community

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Prevalence of white coat effect in treated hypertensive patients in the community

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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