Abstract
Previously we estimated the prevalence of essential hypertension (EH) as around 0.1% and suggested that male gender, obesity, and strong genetic background (hypertension in parents) were risk factors for EH in a young population aged less than 30 based on targeted screening for hypertension at a university health check-up. This study also revealed a high incidence of white coat hypertension (WCH) in university students, and thus, we continued this screening for four consecutive years, and examined the prognosis and clinical characteristics of young-onset WCH. Three occasions of casual blood pressure (BP) measurement and additional home BP measurement revealed 72 WCH and 15 EH students (all males) during the 4-year study period. None of the WCH students had elevated home BP to the level of hypertension during their stay at university, and 26 out of 38 WCH students participating screening in the following years showed normal casual BP. Although WCH students showed a significantly higher pulse rate than controls, WCH could not be fully differentiated from EH either by pulse rate or by correlation between casual BP value and pulse rate. These findings indicate the requirement of longer follow-up after graduation to determine the prognosis of young-onset WCH, though EH and WCH in the young population share the same risk factors and, possibly, autonomic nervous system dysfunction. Since diagnosis of WCH has limited importance for university students, screening of EH following a general health check-up would elevate the clinical validity of casual BP measurement at the university.
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Ejima Y, Hasegawa Y, Sanada S, et al: Characteristics of young-onset hypertension identified by targeted screening performed at a university health check-up. Hypertens Res 2006; 29: 261–267.
Verdecchia P, Schillaci G, Borgioni C, Gattobigio R, Ciucci A, Porcellati C : White coat hypertension. Lancet 1996; 348: 1444–1445.
Khattar RS, Senior R, Lahiri A : Cardiovascular outcome in white-coat hypertension versus sustained mild hypertension: a 10-year follow-up study. Circulation 1998; 98: 1892–1897.
Kario K, Shimada K, Schwartz JE, Matsuo T, Hoshide S, Pickering TG : Silent and clinically overt stroke in older Japanese subjects with white coat and sustained hypertension. Am J Hypertens 2001; 14: 855–860.
Kawabe H, Shibata H, Hirose H, Tsujioka M, Saito I, Saruta T : Determinants for the development of hypertension in adolescents. A 6-year follow-up. J Hypertens 2000; 18: 1557–1561.
Kawasaki T, Uezono K, Sanefuji M, et al: A 17-year follow-up study of hypertensive and normotensive male university students in Japan. Hypertens Res 2003; 26: 445–452.
Frontini MG, Srinivasan SR, Elkasabany A, Berenson GS : Awareness of hypertension and dyslipidemia in a semirural population of young adults: the Bogalusa Heart Study. Prev Med 2003; 36: 398–402.
Sharabi Y, Grotto I, Huerta M, et al: Susceptibility of the influence of weight on blood pressure in men versus women: lessons from a large-scale study of young adults. Am J Hypertens 2004; 17: 404–408.
Kavey R-E W, Kveselis DA, Atallah N, Smith FC : White coat hypertension in childhood: evidence for end-organ effect. J Pediatr 2007; 150: 491–497.
Buchhols K, Schachinger H, Wagner M, Sharma AM, Deter HC : Reduced vagal activity in salt-sensitive subjects during mental challenge. Am J Hypertens 2003; 16: 531–536.
Guzzetti S, Piccaluga E, Casati R, et al: Sympathetic predominance in essential hypertension a study employing spectral analysis of heart rate variability. J Hypertens 1988; 6: 711–717.
Mancia G : The sysmpathetic nervous system in hypertension. J Hypertens 1997; 15: 1553–1565.
Neumann SA, Jennings JR, Muldoon MF, Manuck SB : White-coat hypertension and autonomic nervous system dysregulation. Am J Hypertens 2005; 18: 584–588.
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Toyama, H., Hasegawa, Y., Ejima, Y. et al. Characteristics of Young-Onset White Coat Hypertension Identified by Targeted Screening for Hypertension at a University Health Check-Up. Hypertens Res 31, 1063–1068 (2008). https://doi.org/10.1291/hypres.31.1063
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DOI: https://doi.org/10.1291/hypres.31.1063