Efeito hipertensäo e normotensäo do avental branco na liga de hipertensäo do Hospital das Clínicas, FMUSP. Prevalência, características clínicas e demográficas / White-coat hypertension and normotension in the league of hypertension of the Hospital das Clínicas, FMUSP. Prevalence, clinical and demographic characteristics

OBJECTIVE: To assess the prevalence of white-coat normortension, white-coat hypertension, and white-coat effect. METHODS: We assessed 670 medical records of patients from the League of Hypertension of the Hospital das Clínicas of the Medical School of the University of Säo Paulo. White-coat hypertension (blood pressure at the medical office: mean of 3 measurements with the oscillometric device ³140 or ³90 mmHg, or both, and ambulatory blood pressure monitoring mean during wakefulness < 135/85) and white-coat normotension (office blood pressure < 140/90 and blood pressure during wakefulness on ambulatory blood pressure monitoring ³ 135/85) were analyzed in 183 patients taking no medication. The white-coat effect (difference between office and ambulatory blood pressure > 20 mmHg for systolic and 10 mmHg for diastolic) was analyzed in 487 patients on treatment, 374 of whom underwent multivariate analysis to identify the variables that better explain the white-coat effect. RESULTS: Prevalence of white-coat normotension was 12 percent, prevalence of white-coat hypertension was 20 percent, and prevalence of the white-coat effect was 27 percent. A significant correlation (p<0.05) was observed between white-coat hypertension and familial history of hypertension, and between the white-coat effect and sex, severity of the office diastolic blood pressure, and thickness of left ventricular posterior wall. CONCLUSION: White-coat hypertension, white-coat normotension, and white-coat effect should be considered in the diagnosis of hypertension

Monitorizaçäo residencial da pressäo arterial e monitorizaçäo ambulatorial da pressäo arterial versus medida de pressäo arterial no consultório / Home blood pressure measurement and ambulatory blood pressure measurement versus office blood pressure measurement

Objetivos - Comparar a monitorização residencial da pressão arterial (MRPA) e monitorização ambulatorial da pressão arterial (MAPA) com os registros de consultório e correlacionar o índice de massa de ventrículo esquerdo (IMVE) com a MRPA e medida de consultório. Métodos - Protocolo 1 - Sessenta e oito hipertensos (58+12 anos, 37 mulheres) realizaram: a) MRPA durante 7 dias; b) MAPA de 24h; e c) medida da pressão arterial no consultório, pelo médico. Protocolo 2 - 41 hipertensos (48+14 anos, 25 mulheres) além de MRPA e medida no consultório, realizaram ecocardiograma bi-dimensional. Resultados - Protocolo 1 - a medida de consultório (153+24/96+13mmHg) foi maior (p<0,05) do que a obtida pela MRPA (133+18/84+12mmHg). Protocolo 2 - o IMVE mostrou correlação com as médias de pressão sistólica/diastólica da MRPA (r=0,02/0,22, p>0,05). Conclusão - A MRPA apresentou menores do que a medida de consultório e semelhantes aos da MAPA, além de melhor correlação com IMVE do que a medida de consultório.