Decisions and therapeutic attitudes for patients with white coat hypertension

Objective. To analyze the different therapeutic attitudes towards patients with arterial hypertension (AH) or white coat hypertension (WCH). Design. Longitudinal, retrospective study after performing a 24 h ambulator y blood pressure monitoring of ABPM. Setting. Urban health center. Patients. Eighty-six patients aged over 15 years, not treated and with figu res of a poor blood pressure control (> 140 and/or > 90 mmHg), followed for a mean of four years. Intervention. Initial 24-h ABPM (SpaceLabs 90202-902 07), Determinations and main results. After ABPM 43 patients were classified as having WCH and 43 patients AH. Both groups were comparable. Pharmacologic t reatment was begun from 41.9% (n = 18) of WCH and 88.4% (n = 38) of AH (p < 0.001) patients with a delay, after ABPM, of 19 months (SD 22) and 1.2 mon ths (SD 3.2), respectively (p < 0.01). At the end of the follow-up period p atients with AH had more target organs involved. Conclusions. The information provided by ABPM probably entails a more conse rvative approach at the beginning of pharmacologic treatment.