Aziz, Nasir Raza, Sajid Ubaidullah, Jawad Zaheer, Javaid Akbar khan, Mumtaz Hassan, Javaid Akbar Khan.
Role of Ambulatory Blood Pressure Monitoring in Diagnosing White Coat Hypertension.
Ann King Edward Med Uni Jan ;5(3,4):266-9.

This study was conducted on 300 patients with mild to moderate hypertension attending the Hypertension Clinic, Mayo Hospital, Lahore. Patients included in the study underwent clinical interview, measurement of blood pressure on three separates visits, determination of serum lipids, glucose, uric acid and serum electrolytes. Urine examination, X-ray chest, abdominal ultrasonography, electrocardiography, and M-mode and 2-D echocardiography were also performed. Patients with severe hypertension, secondary hypertension and target organ damage were excluded. These patients were then called for 24-hours ambulatory blood pressure monitoring with Welch-Allyn-Tycos A.B.P.M. The system was programmed to measure blood pressure every thirty minutes during the day (7 am. to 11 p.m.) and every sixty minutes during night (11 p.m. to 7 am.). The subjects were instructed to remain still when cuff inflation occurred and to have the arm relaxed and extended during measurements. They were otherwise encouraged to continue their routine work. The mean of three clinic readings and the 24 hour ambulatory readings were used to determine the incidence of white coat hypertension, which has been defined as high clinic values with normal home or ambulatory readings. The study revealed a 26.6% prevalence of white coat hypertension in our society as compared to the western figure of 20-30%. The majority of patients having white coat hypertension had normal blood pressure during their resting hours especially at night. In view of our findings we suggest that patients with mild to moderate hypertension should be evaluated with A.B.P.M. to rule out white coat hypertension before initiating drug therapy.

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