White coat hypertension detected during screening of male adolescent athletes

We investigated the utility of the selective use of ambulatory BP monitoring (ABPM) and echocardiography in detecting truly hypertensive adolescents from a cohort of young adolescent athletes undergoing BP screening. A total of 410 athletes (aged 16.4+/-2.6 years) were screened and, if initial BP measurement detected a persistently elevated BP (>140 mm Hg systolic or >90 mm Hg diastolic), ABPM and echocardiography were performed. Eighteen clinically hypertensive cases (4.4%) were detected and evaluated with a 24-h ABPM. Sixteen of them were defined as having "white coat hypertension" because they were detected to have normal daytime and nocturnal BP. An elevated level of BP confirmed on ABPM was recorded in only two (0.5%) athletes. Echocardiography failed to demonstrate significant abnormalities.