Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension
Our study evaluated whether there were differences in the prevalence of white-coat hypertension (WH) and masked hypertension (MH) based on the 2018 ESC/ESH and 2017 ACC/AHA hypertension guidelines in Korea. The motivation was the lowering of the diagnostic threshold for hypertension in the 2017 ACC/...
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MDPI AG
2020-05-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/8/2/122 |
| _version_ | 1797568887279058944 |
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| author | Byong-Kyu Kim Moo-Yong Rhee |
| author_facet | Byong-Kyu Kim Moo-Yong Rhee |
| author_sort | Byong-Kyu Kim |
| collection | DOAJ |
| description | Our study evaluated whether there were differences in the prevalence of white-coat hypertension (WH) and masked hypertension (MH) based on the 2018 ESC/ESH and 2017 ACC/AHA hypertension guidelines in Korea. The motivation was the lowering of the diagnostic threshold for hypertension in the 2017 ACC/AHA guidelines. Of 319 participants without antihypertensive drug history and with suspected hypertension based on outpatient clinic blood pressure (BP) measured by physicians, 263 participants (51.6 ± 9.6 years; 125 men) who had valid research-grade office BP and 24-h ambulatory BP measurements were enrolled. WH prevalence based on daytime ambulatory BP among normotensive individuals was lower with the ESC/ESH guidelines than the ACC/AHA guidelines (29.0% vs. 71.4%, <i>p</i> < 0.001). However, MH prevalence based on daytime ambulatory BP among hypertensive individuals was higher based on the ESC/ESH guidelines (21.6% vs. 1.8%, <i>p</i> < 0.001). Seventy percent of WH cases (2017 ACC/AHA guidelines) and 95.2% of MH cases (2018 ESC/ESH guidelines) occurred in individuals with systolic BP of 130–139 mmHg and/or diastolic BP of 80–89 mmHg. The diagnostic threshold of the 2017 ACC/AHA guidelines yielded a higher prevalence of WH compared to that of the 2018 ESC/ESH guidelines. However, the prevalence of MH was higher with the 2018 ESC/ESH guidelines than with the 2017 ACC/AHA guidelines. The high prevalence of WH and MH in people with a systolic BP of 130–139 mmHg or diastolic BP of 80–89 mmHg suggests the need for a more active out-of-office BP measurement in this patient group. |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T20:03:13Z |
| publishDate | 2020-05-01 |
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| series | Healthcare |
| spelling | doaj.art-2c6805ac26ed4226a7d485d675fe1f362023-11-19T23:24:17ZengMDPI AGHealthcare2227-90322020-05-018212210.3390/healthcare8020122Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked HypertensionByong-Kyu Kim0Moo-Yong Rhee1Division of Cardiology, Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju Hospital, Gyeongju 38067, KoreaCardiovascular Center, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi 10326, KoreaOur study evaluated whether there were differences in the prevalence of white-coat hypertension (WH) and masked hypertension (MH) based on the 2018 ESC/ESH and 2017 ACC/AHA hypertension guidelines in Korea. The motivation was the lowering of the diagnostic threshold for hypertension in the 2017 ACC/AHA guidelines. Of 319 participants without antihypertensive drug history and with suspected hypertension based on outpatient clinic blood pressure (BP) measured by physicians, 263 participants (51.6 ± 9.6 years; 125 men) who had valid research-grade office BP and 24-h ambulatory BP measurements were enrolled. WH prevalence based on daytime ambulatory BP among normotensive individuals was lower with the ESC/ESH guidelines than the ACC/AHA guidelines (29.0% vs. 71.4%, <i>p</i> < 0.001). However, MH prevalence based on daytime ambulatory BP among hypertensive individuals was higher based on the ESC/ESH guidelines (21.6% vs. 1.8%, <i>p</i> < 0.001). Seventy percent of WH cases (2017 ACC/AHA guidelines) and 95.2% of MH cases (2018 ESC/ESH guidelines) occurred in individuals with systolic BP of 130–139 mmHg and/or diastolic BP of 80–89 mmHg. The diagnostic threshold of the 2017 ACC/AHA guidelines yielded a higher prevalence of WH compared to that of the 2018 ESC/ESH guidelines. However, the prevalence of MH was higher with the 2018 ESC/ESH guidelines than with the 2017 ACC/AHA guidelines. The high prevalence of WH and MH in people with a systolic BP of 130–139 mmHg or diastolic BP of 80–89 mmHg suggests the need for a more active out-of-office BP measurement in this patient group.https://www.mdpi.com/2227-9032/8/2/122hypertensionguidelineswhite coat hypertensionmasked hypertensionambulatory blood pressure |
| spellingShingle | Byong-Kyu Kim Moo-Yong Rhee Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension Healthcare hypertension guidelines white coat hypertension masked hypertension ambulatory blood pressure |
| title | Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension |
| title_full | Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension |
| title_fullStr | Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension |
| title_full_unstemmed | Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension |
| title_short | Impact of 2018 ESC/ESH and 2017 ACC/AHA Hypertension Guidelines: Difference in Prevalence of White-Coat and Masked Hypertension |
| title_sort | impact of 2018 esc esh and 2017 acc aha hypertension guidelines difference in prevalence of white coat and masked hypertension |
| topic | hypertension guidelines white coat hypertension masked hypertension ambulatory blood pressure |
| url | https://www.mdpi.com/2227-9032/8/2/122 |
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