Hypertension, Vol 16, 617-623, Copyright © 1990 by American Heart Association
S Julius, A Mejia, K Jones, L Krause, N Schork, C van de Ven, E Johnson, J Petrin, MA Sekkarie and SE Kjeldsen
During a survey of young subjects not receiving treatment for hypertension
in Tecumseh, Michigan, clinic and self-monitored blood pressures taken at
home (14 readings in 7 days) were obtained in 737 subjects (387 men, 350
women, average age 31.5 years). Hypertension in the clinic was diagnosed if
the clinic blood pressure exceeded 140 mm Hg systolic or 90 mm Hg
diastolic. In the absence of firm criteria for what constitutes
hypertension at home, subjects whose average home blood pressure was in the
upper decile of the whole population were considered to have hypertension
at home. By these criteria, 7.1% of the whole population had "white coat"
hypertension (i.e., high clinic but not elevated home readings). The
prevalence of "sustained" hypertension (i.e., high readings in the clinic
and at home) was 5.1%. Subjects with white coat and sustained borderline
hypertension in Tecumseh were very similar. Both groups showed, at previous
examinations (at ages 5, 8, 21, and 23 years), significantly higher blood
pressure readings than the normotensive subjects. As young adults (average
age 33.3 years), the parents of both hypertensive groups had significantly
higher blood pressure readings than the parents of normotensive subjects.
Both hypertensive groups had faster heart rates, higher systemic vascular
resistance, and higher minimal forearm vascular resistance. Both
hypertensive groups were more overweight, had higher plasma triglycerides,
insulin, and insulin/glucose ratios than normotensive subjects. The white
coat hypertensive group also had lower values of high density lipoprotein
than the normotensive group. White coat hypertension is a frequent
condition.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
"White coat" versus "sustained" borderline hypertension in Tecumseh, Michigan
University of Michigan, Division of Hypertension, Ann Arbor.
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