Chest
Clinical InvestigationsCARDIOLOGYWhite Coat Hypertension in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome
Section snippets
Subjects
Ninety-six consecutive patients with OSAHS were selected for study. Patients were excluded from the study for the following reasons: (1) unwillingness or inability to perform the testing procedure; (2) obstructive or restrictive lung disease demonstrated on pulmonary function testing; (3) congestive heart failure, valvular heart disease, or atrial fibrillation; (4) suspected secondary hypertension; (5) current drug or mechanical treatment for sleep apnea; (6) therapy with steroids, nonsteroidal
Results
Office hypertension was diagnosed in 45 patients with OSAHS. Thirty-five of these subjects were in World Health Organization hypertension stage 1 (systolic BP < 159 mm Hg, diastolic BP < 99 mm Hg), 8 patients were in stage 2 (systolic BP, 160 to 179 mm Hg/diastolic BP, 100 to 109 mm Hg), and 2 patients were in stage 3 (systolic BP > 180 mm Hg/diastolic BP >110 mm Hg). The normotensive OSAHS group was composed of 54 patients. After ABPM determination, hypertension was confirmed in 30 patients
Discussion
This study, the first to our knowledge to analyze the WCH phenomenon in patients with OSAHS, showed that one third of these patients, diagnosed hypertensives with office BP measurements, presented WCH. Although published estimates vary widely, WCH has been reported to occur in approximately 30% of hypertensive patients.212223 The highest prevalence of WCH has been described in diabetic patients. In patients with type 2 diabetes mellitus, prevalence of WCH ranges from 23 to 62%, and reaches 74%
ACKNOWLEDGMENT
The investigators thank A. Alvarez, P. Librán, A. Pérez, and C. Suárez for technical assistance.
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Supported by grants 96/1280 and 99/0252 from Fondo de Investigación Sanitaria, and Neumomadrid (2000).