Prevalence of White Coat and Masked Hypertension Among Thai Hypertensive Patients an Analysis of TeleHealth Assisted Intervention in Home Blood Pressure Monitoring (THAI HBPM) Nationwide Pilot Project
Abstract:
Background: Recent guidelines recommended the monitoring of home blood pressure (HBP) for the diagnosis and management of white-coat hypertension (HT), masked HT, HT with white-coat effect and HT with masked effect. Objectives: To investigate the prevalence and characteristics of HT subtypes using HBP measurement with telehealth-assisted technology. Methods: We conducted a prospective study in HT clinics. Adult hypertensive patients were enrolled and instructed to measure HBP using the telehealth HBP machine. The HBP, clinic blood pressure, and clinical data were obtained and recorded in the web-based system. Hypertension subtypes were classified according to the treatment status, CBP (≥ or <140/90 mmHg) and HBP (≥ or <135/85 mmHg). Results: A total of 1,184 patients were enrolled. In the untreated patients, the prevalence of white-coat HT and masked HT were 25.7% and 6.9%. In the medically treated patients, the prevalence of hypertension with white-coat effect and HT with masked effect were 23.3% and 9.6%, respectively. Conclusions: Almost one fourth of Thai hypertensive adults were found to have white-coat HT. The HBPM with the web-based system is a valuable tool for screening, diagnosis and long-term blood pressure control in hypertensive patients.