Detection and analysis of primary hypertension, masked hypertension and white coat hypertension with ambulatory blood pressure method in our center

Objective: It was aimed to detect primary hypertension, masked hypertension and white coat hypertension in patients admitted to KTU Farabi Hospital Hypertension and Nephrology Clinic and to analyze the data at the time of admission. Materials and Methods: Between 01.06.2018 and 30.06.2022, a total of 237 patients who met the inclusion criteria were included among 858 patients who applied to Karadeniz Technical University Hypertension and Nephrology outpatient clinic and underwent ambulatory blood pressure measurement. Demographic characteristics, office blood pressure, home blood pressure, ambulatory blood pressure measurements, laboratory and clinical findings were analyzed. The study was performed as a single center and retrospective file review. Findings: Among the patients included in the study, 14.8% (n=35) were normotensive and 85.2% (n=202) had hypertension. Hypertension was found in 81.3% of women and 88.8% of men. Among patients with hypertension, 17.3% (n=35) had masked hypertension, 16.3% (n=33) had white coat hypertension and 66.3% (n=134) had sustained hypertension. There was no significant difference between gender and the presence of hypertension. The mean age of the subjects with sustained hypertension was 56.07±14.71 years, the mean age of the subjects with masked hypertension (MHT) was 50.94±17.21 years, the mean age of the subjects with white coat hypertension (WCH) was 50.4±15.30 years, and the mean age of the normotensive subjects was 48.08±15.12 years, and a significant difference was found between the subjects with sustained hypertension and normotensive subjects in terms of mean age values. Body mass index (BMI) was ≥30 kg/m2 in 48.5% (n=98) of the hypertensive subjects and no significant difference was found between the hypertensive groups. When biochemical parameters were analyzed, hemoglobin values of the group with masked hypertension were higher than those with sustained hypertension. When LDL, uric acid, glucose, sodium and potassium values were analyzed, there was no statistically significant difference between the groups. When ambulatory blood pressure parameters of those with masked hypertension and sustained hypertension were analyzed, daytime mean blood pressure, nighttime mean blood pressure and all-day mean blood pressure values were statistically significantly higher than those with white coat hypertension and normotension. Results: In our study, the findings were mostly similar to the literature. However, when biochemical parameters were analyzed in other studies, elevated uric acid and glucose values were observed in patients with sustained hypertension compared to other groups, while no difference was observed in these values between the groups in our study. ABPM has an important place in the diagnosis and treatment of primary hypertension, masked hypertension and white coat hypertension. However, demographic characteristics, laboratory parameters, radiologic imaging, additional comorbidities, home blood pressure measurement and office blood pressure measurement are among the parameters that help the diagnosis and should be evaluated together with ABPM. The most important limiting factor in our study is that the study was conducted in a single center and the number of patients was small. This situation negatively affects the inclusiveness of the study results and it is recommended to be supported by multicenter studies. Keywords: 24-hour ambulatory blood pressure measurement, ABPM, white coat hypertension, masked hypertension, primary hypertension , sustained hypertension