Assessment of stress related hypertension [white coat hypertension] in a primary health care setting: a growing concern for community health physicians

ABSTRACT

The aim of this study was to identify the prevalence of white coat hypertension and explore the relation ship between hypertension and unnecessary medication for its treatment. Cross-sectional study design. Family hospital E-11 Golra situated in rural area of Islamabad Capital territory, a primary health care setting with indoor and outdoor facilities. This cross-sectional study was conducted on 96 patients of mild to moderate hypertension coming to medical clinic Family hospital Golra situated in rural area of Islamabad from Jan 2008 to Dec 2008, having elevated blood pressure in the clinic on at least three different occasions. AMBM was purchased and monitoring was done through a trained cardiac paramedic. Results of the ambulatory blood pressure monitoring were recorded, assessed on SPSS The prevalence of white coat hypertension and other findings were analyzed. 96 patients [51 males and 45 females] were included in this study and the clinical evaluation of all the cases was done to rule out secondary hypertension. Urine complete examination and serum levels of urea, creatinine, glucose and fasting lipids profile were done in all the cases undergoing study. Patients were also screened with non-invasive techniques like X-ray chest, abdominal ultrasonography and echocardiography in tertiary care hospital. These laboratory findings were later on compared and assessed on the basis of history and physical examination. The study revealed 29% prevalence of white coat hypertension in previously diagnosed cases of mild to moderate hypertension in our community as compared to the international figures of 20-30% in western society