Ambulatory blood pressure measurement in the main cities of Cameroon: prevalence of masked and white coat hypertension, and influence of body mass index

Abstract

Introduction: identifying White Coat Hypertension (WCH) may avoid inappropriate commitment of individuals to lifelong and costly blood pressure (BP) lowering  medications’. We assessed the prevalence and determinants of WCH in urban clinical settings in Cameroon.

Methods: participants were a consecutive sample of adults, who underwent ambulatory BP  measurements (ABPM) for the diagnosis of hypertension and  evaluation of treatmentin three referral cardiac clinics in the cities of Yaounde and Douala, between January 2006 and July 2011. WCH was defined as an office-based systolic (or diastolic) BP ≥ 140(90) mmHg together with an average day time  ambulatory systolic (and diastolic) BP < 135(85) mmHg. 

Results: of the 500 participants included, 188 (37.6%) were women, 230 (46%) were nonsmokers and 53 (10.6%) had diabetes mellitus. The mean age was  51.6±10.2years. The ABPM readings were higher in men than in women

Conclusion: the prevalence of WCH was high in our study population and was correlated only with BMI. Accurate measurement of BP and appropriate diagnosis of hypertension using ABPM in this setting may help limiting the consequences of over estimating hypertension severity on individuals, families and health  systems.

Key words: White Coat Hypertension, determinants, diagnosis, Ambulatory Blood Pressure Monitoring