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Examining white coat hypertension at a free high blood pressure clinic
Thesis

Examining white coat hypertension at a free high blood pressure clinic

Megan Patricia Donohue
Master of Public Health (M.P.H.), Drexel University
Jun 2011
DOI:
https://doi.org/10.17918/etd-3590
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Donohue_Megan_2011565.33 kB
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Abstract

Free Clinics White Coat Syndrome Hypertension Public Health
Introduction: White coat hypertension is a phenomenon in which a patient's blood pressure in a clinic setting exceeds the patient's blood pressure in other settings. Studies suggest this occurs in anywhere from ten to thirty percent of patients. The identification of such is important as it may prevent unwarranted use of anti-hypertensive medications. Objectives: The main goal of this study was to quantify the prevalence of white coat hypertension at a free blood pressure clinic in Richmond, VA. The examination of blood pressure differences between clinic settings and other settings on a group and individual level was fundamental to this study. Further analyses were then included to examine risk factors associated with uncontrolled hypertension in attempt to develop a predictive model. Methods: Longitudinal data was collected from ambulatory blood pressure monitors of 16 patients from the Richmond Center for High Blood Pressure. This data was merged with data collected from retrospective chart reviews to obtain laboratory values for possible risk factors. Paired t-tests were used to examine differences between clinic and home measurements on a group level. The examination of individual agreement and regression analysis to develop a predictive model was also undertaken. Results: Twenty-five percent of subjects included in this study suffered from white coat hypertension. Overall, there was no difference between clinic and home blood pressure measurements on the group level. However, individual agreement was poor. Regression analysis showed high density lipoprotein was positively associated with and triglycerides were negatively associated with an increased percent of uncontrolled hypertension. Conclusion: White coat hypertension is a phenomenon that is present at the Richmond Center for High Blood Pressure. Recognition of this has the potential to be economically advantageous for the clinic. Due to a small sample size, results of this analysis are not considered predictive models. However, future research in this field would be served well to explore these preliminary findings with larger samples.

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