White coat hypertension: clinical performance after its primary care diagnosis

To find the clinical performance after the diagnosis of White Coat Hypertension (WCH) by out-patient monitoring of blood pressure (OMBP). Descriptive, crossover study. Primary Care. "La Orden" Health Centre, Huelva. All the individuals diagnosed with WCH in 1995-6-7. WCH was defined as over 3 clinical measurements of blood pressure (BP) above 140 and/or 90 mmHg, and mean figures after OMBP below 135 and 85 mmHg for day-time systolic and diastolic pressure, respectively. Initial OMBP was measured (Spacelabs 90207) and clinical histories were audited after monitoring. Means of clinical BP and systolic, diastolic and mean BP through OMBP were calculated. Clinical performance was assessed in four variables: 1) Counselling on life-style; 2) Periodic clinical BP controls; 3) Correct handling of OMBP; and 4) Correct indication of drug treatment. Statistical tests were used. 110 individuals diagnosed with WCH were included (49.14-10 years). Counselling on life-style took place in 41%, periodic control of clinical BP in 50%, correct handling of OMBP in 31.8%. Drug treatment was begun in 30.9%, with its indication correct in 47.1% of them. Life-style counselling, periodic control of clinical BP and correct handling of OMBP was scant (41, 50 and 31%), with a third of these diagnosed as hypertense and drug treatment without a correct criterion being indicated in half of the latter. Clinical treatment of WCH is not homogeneous.