White-coat, masked and sustained hypertension detected by home blood pressure monitoring in adolescents: prevalence and associated factors

Blood Press. 2018 Jun;27(3):151-157. doi: 10.1080/08037051.2017.1422388. Epub 2018 Jan 5.

Abstract

Purpose: Population-based studies estimating prevalence's of white-coat, masked and sustained hypertension in non-European adolescents are needed, particularly in developing countries. Aiming to determine these estimates and, additionally identify factors associated to these conditions this study was conducted.

Materials and methods: Cross-sectional study with a representative sample of secondary school students from a Brazilian state capital. Office measurements were performed with validated semi-automatic devices. Home BP (blood pressure) monitoring protocol included two day-time and two evening-time measurements over 6 days. Adolescents' were classified as: normotensives (office and home BP <95th percentile); sustained hypertensives (office and home BP ≥95th percentile); white-coat hypertensives (office BP ≥95th percentile and home BP <95th percentile) and masked hypertensives (office BP <95th percentile and home BP ≥95th percentile). Logistic regression models were built to identify if sex, age, BMI and family history of HTN were independently associated with white-coat, masked and sustained hypertension.

Results: In a sample of 1024 adolescents, prevalence of white-coat, masked and sustained hypertension was 7.5%, 2.2% and 1.7%, respectively. Male sex was positively associated with white-coat hypertension (OR 2.68; 95%CI 1.58-4.54; p < 0.001). BMI was positively associated with both white-coat (OR 1.23; 95%CI 1.16-1.30; p < 0.001) and sustained hypertension (OR 1.19; 95%CI 1.11-1.29; p < 0.001). None of the independent variables were associated with masked hypertension in this population.

Conclusion: The estimated prevalence of white-coat hypertension, masked and sustained hypertension in a population of non-European adolescents assessed by home BP monitoring was 7.5%, 2.2% and 1.7% respectively. Male sex was positively associated with white-coat hypertension in these adolescents while BMI was positively associated with both white-coat and sustained hypertension.

Keywords: Pediatric; blood pressure measurement/monitoring; diagnostic method; home blood pressure; masked hypertension; white-coat hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Pressure Monitoring, Ambulatory / methods*
  • Body Mass Index
  • Brazil
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / etiology
  • Logistic Models
  • Male
  • Prevalence
  • Risk Factors
  • Sex Factors
  • White Coat Hypertension / epidemiology*
  • White Coat Hypertension / etiology