Age and Gender Differences in White Coat Phenomenon of Blood Pressure
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概要
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Home blood pressure has recently become a widely used measurement in the diagnosis and management of hypertension. Home blood pressure readings often differ from blood pressure readings taken during patient clinic visits due to what is referred to as the "white coat" phenomenon. In other words, blood pressure readings taken by a medical professional in a medical setting tend to be elevated in comparison to blood pressure readings taken by the patients themselves at home, a fact that is generally taken into consideration when a patient's condition is being reviewed. However, the effects of patient age and gender on white coat phenomenon have not been well studied. To investigate the relationship of these factors to white coat phenomenon, we studied 288 residents (119 men and 169 women, all over 40 years of age) of a rural community in southern Japan. White coat phenomenon was evaluated in each subject by subtracting mean morning home blood pressures, both systolic and diastolic, from regular-checkup blood pressure. The difference in systolic blood pressures in men over 65 years of age was significantly greater than that in men under age 65. No age-related differences were observed in systolic pressures among the women in our study. While the difference between home systolic blood pressure and regular-checkup systolic blood pressure in women under 65 years of age was significantly greater than that in men of the same age group, no gender-related differences were observed in subjects over 65. In contrast to the results for systolic blood pressure, there were no age- or gender-related differences in diastolic blood pressures. Age- and gender-related differences seen in the systolic blood pressures were not mimicked in other parameters such as serum total cholesterol levels, serum triglycerides levels, or fasting blood sugar levels. These results support the importance of considering white coat phenomenon as a factor in the out-patient clinical setting, which should be taken into account in the treatment of hypertension, especially in women and older men.
- 長崎大学の論文