The Role Of Home Blood Pressure Self-test In White Coat Hypertension Patient

Objective : In recent years,experts and scholars had many opinions on prevention and controlling of white coat hypertension(WCH),as the government pay high attention to hypertension.This study aims to evaluate the the home blood pressure self-test(HBPM)on the diagnosis and treatment of WCH patients,and provide a scientific basis for diagnosis and treatment of white coat hypertension in the future.Methods: 252 cases of patients with hypertension were selected in the cardiology outpatient department,the affiliated hospital of Qingdao University from October 2015 to February 2016.63 cases with WCH wer diagnosed by 24 hours ambulatory blood pressure monitoring(ABPM)and HBPM.The general situation of patients with WCH,life behavior,family blood pressure were investigated by questionnaire and the incidence of WCH were Analyzed in different groups.63 cases of WCH patients were randomly divided into study group(32 cases)and normal group(31 cases).Self-test group patients underwent clinic blood pressure measurement(CBPM),24 ABPM and HBPM and conventional group underwent CBPM and 24 ABPM.Then All the patients were required to remodify lifestyles.Results of HBPM and 24 h ABPM blood pressure,the way of life in patients with blood pressure and improving the situation were compared in two groups after 1 2-week follow-up.Results: 63 patients were diagnosed WCH In 252 patients with high blood pressure,WCH detection rate is 25%.The incidence of female WCH was 27.69% and the incidence of male WCH is 22.13%.Ranging in age from 18 to 44 patients,the incidence of WCH is9.10%.When the age is between t 45 to 59 years old.The incidence of WCH is24.75%.While the age is more than 60 years old,the incidence of new hypertension patients in WCH is 27.91%,The difference was statistically significant(= 20.57,p <0.05).WCH has the highest incidence was 33.56% in level 1 hypertension patients.The incidence of WCH was 15.66% in level 2.level 3 had the lowest incidence of WCH which was 4.34% in patients with high blood pressure.After following up for 12 weeks,patients of self-test group improved significantly than the conventional group in such aspects as salt intake,exercise and BMI..After 12 weeks,there is significant difference when patients’ blood pressure self-test group success rate was 31.25% which was higher than normal group 9.68%(=4.47,P<0.05).Systolic blood pressure of self-test group lower obviously than the normal group,with significant difference(t = 3.78,P <0.001).Collecting blood pressure self-test group form for 12 weeks of patients.,then we compared with the twice 24 ABPM.There is no significant difference between self-test group HBPM for many times of the average of the systolic and diastolic blood pressure and 24 ABPM systolic and diastolic blood pressure(P>0.05).HBPM could be an important method of WCH screening.Conclusion: WCH is common in outpatient department Long-term monitoring,management is necessary in order to prevent and delay the development into a persistent high blood pressure When it is diagnosed.HBPM have effects similar to 24 ABPM effect in WCH diagnosis.It could guide the treatment of patients with WCH and improved lives style.If someone was diagnosed WCH,blood pressure should be monitored,managed,and to prevent and delay developing into sustained hypertension for a long time.And HBPM played an important role in guiding on treatment of patients with WCH and lifestyle promotion.HBPM also could effectively prevent excessively treatment in patients with WCH.Thus doctors should actively promote and guide and encourage patients to monitor blood pressure by themselves.