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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한고혈압학회 Clinical Hypertension Clinical Hypertension 제25권 제2호
발행연도
2019.1
수록면
23 - 31 (9page)

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Abstract Purpose: The current gold standard for the diagnosis of white-coat effect is by the 24-h ambulatory blood pressure monitoring (ABPM) which may not be readily available in every primary care setting. Previous studies had shown that deep breathing, through modulating the baroreceptor reflex sensitivity to vagal stimulation over 30 to 60 s, was useful in detection of the white-coat effect. The aim of our study was to evaluate the diagnostic accuracy of the deep breathing test (DBT) as compared with the gold standard of ABPM in the diagnosis of hypertension with white-coat effect in Chinese patients in primary care. Methods: This cross sectional study recruited 178 consecutive, eligible, consented, hypertensive patients receiving treatment at a local public primary care Hypertension Clinic. The diagnostic accuracy of the DBT in all recruited patients, patients not taking beta-adrenergic blockers and patients with different clinic SBP cut-off before the DBT by means of area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive and negative predictive values was evaluated. Results: The results for the ROC curves for systolic and diastolic BP changes after the DBT were statistically insignificant. The ROC curve was statistically significant for SBP change in patients not taking beta-adrenergic blockers and with pre-DBT clinic SBP ≥ 165 mmHg (ROC curve area of 0.719, 95% CI 0.53 to 0.91, p = 0.04). The corresponding sensitivity and specificity of the DBT were 40.9 and 90.9% respectively if SBP drop was > 30 mmHg. Conclusion: The DBT, even though could not be clinically applied to all patients, was proven to be a potential screening and diagnostic test for white-coat effect in Chinese hypertensive patients with a pre-test SBP of ≥165 mmHg and who were not taking beta-adrenergic blockers. Trial registration: This study was approved by Kowloon East Cluster/ Kowloon Central Cluster Research Ethics Committee/Institutional Review Board of Hospital Authority of Hong Kong under the registration KC/KE-16-0084/ER-3.

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참고문헌 (35)

참고문헌 신청
Lim SS / 2012 / A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010 : a systematic analysis for the Global Burden of Disease Study 2010 / Lancet 380:2224~2260 google schola Leung G / 2015 / Cohort profile : FAMILY cohort / Int J Epidemiol 46(2):e1 google schola Collins R / 1990 / Blood pressure, stroke, and coronary heart disease. Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context / Lancet 335:827~838 google schola The Hypertension Detection and Follow-up Program Cooperative Group / 1979 / Five-year findings of the hypertension detection and follow-up program: I. reduction in mortality of persons with high blood pressure, including mild hypertension / JAMA 242(23):2562 google schola Falaschetti E / 2009 / Continued improvement in hypertension management in England : results from the Health Survey for England 2006 / Hypertension 53(3):480 google schola

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