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Hypertension, white-coat hypertension and masked hypertension in Australia: Findings from the Australian Diabetes, Obesity, and Lifestyle Study 3
Head, Geoffrey A. Shaw, Jonathan E. Dunstan, David W. Owen, Neville Magliano, Dianna J. Chadban, Steven J. Zimmet, Paul Z.
Head, Geoffrey A.
Shaw, Jonathan E.
Dunstan, David W.
Owen, Neville
Magliano, Dianna J.
Chadban, Steven J.
Zimmet, Paul Z.
Abstract
Background and method: The Australian Diabetes, Obesity, and Lifestyle Study is a national, population-based examination of ~11 000 adults with a third follow-up phase at 12 years. The aim was to use ambulatory blood pressure monitoring (ABPM) in a subsample (n = 508) of the main Australian Diabetes third follow-up cohort to determine the proportion with established, masked or white-coat hypertension in city and regional centers and the effectiveness of diagnosis and treatment. Results: Mean age was 58.9 years, BMI was 27.6 kg/m2 with 53% women. The mean clinic BP was 127/73 mmHg and mean 24-h BP was 121/73 mmHg. Using regression analysis estimations, the predicted ABPM daytime equivalent for the hypertension threshold values of 140/90 mmHg were 136/90 mmHg. There were 43% classified as hypertensive due to either ABPM 24-h more than 130/80 mmHg (17%) or taking antihypertensive therapy (25%). Ambulatory SBP/DBP were higher in men (24-h + 6.4/4.9 mmHg, P < 0.001) compared with women. There was only 3% with white-coat but 21% with masked hypertension indicating 24% misdiagnosis. Based on ABPM, 9% were treated and still hypertensive, which was three times more common in men (14%) than women (4%). Thus 36% had not reached target. There were no differences between urban and rural participants. Based on ABPM, nearly half the participants were hypertensive while only a quarter were taking antihypertensive therapy. Conclusion: The findings highlight the importance of out-of-office BP assessments and the considerable gaps in effectively diagnosing and treating hypertension.
Keywords
ambulatory blood pressure monitoring, blood pressure, hypertension, masked hypertension, men, misdiagnosis, white-coat hypertension, women
Date
2019
Type
Journal article
Journal
Journal of Hypertension
Book
Volume
37
Issue
8
Page Range
1615-1623
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled