Background and objective
White coat effect (WCE) is one of the main bias that can affect office blood pressure (BP) measurement. Therefore, it is a factor must be considered in hypertensives to avoid mistakes in diagnosis and/or treatment. Employment of automated office BP (AOBP) devices could diminish that effect.
Methods
Two studies were designed with the objective of evaluating differences between routinely office and AOBP measurements. WCE was also assessed. First, the TRUE-ESP study included normotensive and hypertensive patients attending specialized consultations at Cardiology, Nephrology, Internal Medicine, Endocrinology and Family Practice. Second, the TRUE-HTA study included hypertensives attending a protocoled Hypertension Unit, with a trained staff.
Results
TRUE-ESP study included 300 patients, 76 % being hypertensives. A significant difference between office BP and AOBP measurement (SBP/DBP 9.8 ¡À 11.6/3.4 ¡À 7.9 mmHg, P < .001) was observed. Percentage of patients gathering WCE criteria was 27.7 % . TRUE-HTA study included 101 hypertensive patients. A significant difference between office BP and AOBP measurement (SBP/DBP 5.7 ¡À 9.3/2.1 ¡À 5.3 mmHg, P < .001) and activity period-ABPM (SBP/DBP 8.5 ¡À 6.7/3.5 ¡À 2.5 mmHg, P < .001) was observed. Percentage of WCE patients was 32.1 % .
Conclusions
Use of AOBP devices can contribute to decrease WCE and to improve accuracy of office BP measurement.
