Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study

Heba Alwan; Menno Pruijm; Belen Ponte; Daniel Ackermann; Idris Guessous; Georg Ehret; Jan A Staessen; Kei Asayama; Philippe Vuistiner; Sandrine Estoppey Younes; Fred Paccaud; Grégoire Wuerzner; Antoinette Pechere-Bertschi; Markus Mohaupt; Bruno Vogt; Pierre-Yves Martin; Michel Burnier; Murielle Bochud

doi:10.1371/journal.pone.0092522

Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study

PLoS One. 2014 Mar 24;9(3):e92522. doi: 10.1371/journal.pone.0092522. eCollection 2014.

Authors

Heba Alwan¹, Menno Pruijm², Belen Ponte³, Daniel Ackermann⁴, Idris Guessous⁵, Georg Ehret⁶, Jan A Staessen⁷, Kei Asayama⁸, Philippe Vuistiner¹, Sandrine Estoppey Younes¹, Fred Paccaud¹, Grégoire Wuerzner², Antoinette Pechere-Bertschi⁹, Markus Mohaupt⁴, Bruno Vogt⁴, Pierre-Yves Martin³, Michel Burnier², Murielle Bochud¹

Affiliations

¹ Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland.
² Service of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland.
³ Service of Nephrology, Department of Specialties, University Hospital of Geneva, Geneva, Switzerland.
⁴ Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
⁵ Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland; Unit of Population Epidemiology, University Hospital of Geneva, Geneva, Switzerland.
⁶ Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland.
⁷ Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
⁸ Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium; Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
⁹ Department of Community Medicine and Primary Care and Emergency Medicine, University Hospital of Geneva, Geneva, Switzerland.

Abstract

Objective: We investigated factors associated with masked and white-coat hypertension in a Swiss population-based sample.

Methods: The Swiss Kidney Project on Genes in Hypertension is a family-based cross-sectional study. Office and 24-hour ambulatory blood pressure were measured using validated devices. Masked hypertension was defined as office blood pressure<140/90 mmHg and daytime ambulatory blood pressure≥135/85 mmHg. White-coat hypertension was defined as office blood pressure≥140/90 mmHg and daytime ambulatory blood pressure<135/85 mmHg. Mixed-effect logistic regression was used to examine the relationship of masked and white-coat hypertension with associated factors, while taking familial correlations into account. High-normal office blood pressure was defined as systolic/diastolic blood pressure within the 130-139/85-89 mmHg range.

Results: Among the 652 participants included in this analysis, 51% were female. Mean age (±SD) was 48 (±18) years. The proportion of participants with masked and white coat hypertension was respectively 15.8% and 2.6%. Masked hypertension was associated with age (odds ratio (OR) = 1.02, p = 0.012), high-normal office blood pressure (OR = 6.68, p<0.001), and obesity (OR = 3.63, p = 0.001). White-coat hypertension was significantly associated with age (OR = 1.07, p<0.001) but not with education, family history of hypertension, or physical activity.

Conclusions: Our findings suggest that physicians should consider ambulatory blood pressure monitoring for older individuals with high-normal office blood pressure and/or who are obese.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Family*
Female
Humans
Male
Masked Hypertension / epidemiology*
Middle Aged
Switzerland / epidemiology
White Coat Hypertension / epidemiology*

Grants and funding

The study is supported by the Swiss National Science Foundation FN 33CM30-124087 and FN 33CM30-140331, with specific funding for Daniel Ackermann, Heba Alwan, Georg Ehret, Idris Guessous, Belen Ponte, and Menno Pruijm. Murielle Bochud was supported by the Swiss School of Public Health Plus. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.