Hipertensión de guardapolvo blanco: evolución a hipertensión sostenida luego de 10 años de seguimiento

Background The long-term outcome of white coat hypertension (WCH) is still controversial despite the extensive information currently available. Objective To evaluate the cumulative incidence of sustained hypertension (SH) among patients with white coat hypertension compared to normotensive patients after 10 years of inclusion in the study. Methods Two hundred and fifty patients of both genders were prospectively included in the study with the following office blood pressure (OBP) and 24-hour ambulatory blood pressure monitoring (ABPM) values : WCH Hypertension Normal BP OBP (mm Hg) . 140 and/or 90 . 140 and/or 90 . 140 and/or 90 ABPM (mm Hg) . 135 and 85 . 135 and 85 . 135 and 85 The patients were divided into two groups: 129 patients with WCH and 121 normotensive patients, and were evaluated after 10 years of follow-up. Glucose blood level, lipid profile and left ventricular mass index (LVMI) were measured. Results Age, gender, smoking habits and glucose blood level were similar at baseline among normotensive patients and patients with white coat hypertension. However, body mass index, total cholesterol levels, lipid levels and LVMI were significantly greater in white-coat hypertensive patients. Sustained hypertension was developed by 48 patients with WCH and 21 normotensive patients. We found an independent association between WCH and SH at 10 years of follow-up [OR: 2.5 (95% CI 1.2-4.2)]. Conclusion Progression to sustained hypertension was greater in patients with white coat hypertension compared to normotensive patients. Introducción No obstante la amplia información en la bibliografía sobre la caracterización de la hipertensión de guardapolvo blanco (HGB), su evolución alejada es hasta el presente tema de controversia. Objetivo Evaluar la incidencia acumulada de hipertensión sostenida (HS) en hipertensos de guardapolvo blanco respecto de normotensos a los 10 años de su inclusión en el estudio. Material y métodos Se incorporaron en forma prospectiva 250 pacientes de ambos sexos, según los siguientes valores de presión de consultorio (PC) y de monitoreo ambulatorio de la presión arterial (MAPA) de 24 horas: Se conformaron dos grupos: 129 hipertensos de guardapolvo blanco y 121 normotensos, los cuales fueron evaluados nuevamente a los 10 años de seguimiento. Se midieron la glucemia, el perfil lipídico y el índice de masa ventricular izquierda (IMVI). Resultados Las variables edad, sexo, tabaquismo y glucemia de normotensos e hipertensos de guardapolvo b