The Utility of Ambulatory Blood Pressure Monitoring for Diagnosing White Coat Hypertension in Older Adults

• Type of Material: Article
• Authors: Kristi Reynolds, Kaiser Permanente Southern California; Christopher Bowling, Emory University; John J. Sim, Kaiser Permanente Los Angeles Medical Center; Lakshmi Sridharan, Columbia University; Teresa N. Harrison, Kaiser Permanente Southern California; Daichi Shimbo, Columbia University
• Language: English
• Date: 2015-11-01
• Publisher: Current Medicine Group
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015, Springer Science+Business Media New York.
• Final Published Version (URL): http://dx.doi.org/10.1007/s11906-015-0599-0
• Title of Journal or Parent Work: Current Hypertension Reports
• ISSN: 1522-6417
• Volume: 17
• Issue: 11
• Start Page: 86
• End Page: 86
• Grant/Funding Information: This work was partially supported by the National Institutes of Health (K24-HL125704) from the National Heart, Lung, and Blood Institute, Bethesda, MD.
• Keywords: Elderly; Peripheral Vascular Disease; ELDERLY PERSONS; METAANALYSIS; CARDIOVASCULAR DISEASE; Science & Technology; Life Sciences & Biomedicine; Cardiovascular System & Cardiology; CLINICAL-PRACTICE; RISK-FACTORS; White coat hypertension; SYSTOLIC HYPERTENSION; Aged; Hypertension; MASKED HYPERTENSION; Ambulatory blood pressure
• Research Categories: Gerontology; Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

The beneficial effect of antihypertensive medication on reducing the risk of cardiovascular disease (CVD) events is supported by data from randomized controlled trials of older adults with hypertension. However, in clinical practice, overtreatment of hypertension in older adults may lead to side effects and an increased risk of falls. The diagnosis and treatment of hypertension is primarily based on blood pressure measurements obtained in the clinic setting. Ambulatory blood pressure monitoring (ABPM) complements clinic blood pressure by measuring blood pressure in the out-of-clinic setting. ABPM can be used to identify white coat hypertension, defined as elevated clinic blood pressure and non-elevated ambulatory blood pressure. White coat hypertension is common in older adults but does not appear to be associated with an increased risk of CVD events among this population. Herein, we review the current literature on ABPM in the diagnoses of white coat hypertension in older adults, including its potential role in preventing overtreatment.