Is Isolated Systolic Hypertension a White Coat’ Phenomenon in the Elderly?
Key result
Clinic systolic blood pressure was 26 mmHg higher than ambulatory blood pressure in elderly subjects with isolated systolic hypertension, compared to a 7 mmHg difference in normotensive controls.
Why the study?
Does repeated clinic blood pressure measurement compared to ambulatory blood pressure monitoring reveal a white coat phenomenon in elderly subjects with isolated systolic hypertension?
Population
21 elderly subjects. None were receiving antihypertensive or vasoactive medication.
Comparison
Repeated clinic blood pressure measurement vs Non-invasive ambulatory blood pressure monitoring
Design
Cohort
Follow-up
4 weeks (four occasions at weekly intervals)
Authors
Discussion
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Member takes
Implication
May overestimate BP severity in elderly ISH; leaves open whether ambulatory monitoring should guide therapy.
Study Design
Type
Observational (n=21)
Structured PICO
Does repeated clinic blood pressure measurement compared to ambulatory blood pressure monitoring reveal a white coat phenomenon in elderly subjects with isolated systolic hypertension?
P
Population
21 elderly subjects (10 with isolated systolic hypertension and 11 normotensive controls) not receiving antihypertensive medication, assessed over 4 weeks.
E
Exposure
Repeated clinic blood pressure measurement (assessed on four occasions at weekly intervals)
C
Comparator
Non-invasive ambulatory blood pressure (ABP) monitoring
O
Outcome
Difference between mean clinic blood pressure and mean daytime ambulatory blood pressure (ABP)surrogate
Elevated systolic blood pressure in elderly patients with isolated systolic hypertension may be largely driven by a white coat pressor response rather than sustained hypertension.
Cite This Study
Silagy et al. (1992) conducted an observational in Isolated systolic hypertension (n=21). Clinic blood pressure measurement vs. Ambulatory blood pressure monitoring was evaluated on Difference between clinic and ambulatory blood pressure. Clinic systolic blood pressure was 26 mmHg higher than ambulatory blood pressure in elderly subjects with isolated systolic hypertension, compared to a 7 mmHg difference in normotensive controls.