Prevalence and clinical correlates of white coat effect in patients with chronic kidney disease and the role of automated blood pressure device in its assessment

Srinivas Shenoy, Shankar Prasad Nagaraju, Nileshwar R. Rau, Ravindra A. Prabhu, Uday Venkat Mateti, Dharshan Rangaswamy, Indu R. Rao, Karan Saraf

Research output: Contribution to journalArticle

Abstract

Context: Hypertension in chronic kidney disease (CKD) is an important modifiable cardiovascular risk factor. Patients with CKD can have clinically significant white coat effect (WCE), making routine clinic blood pressure (BP) measurements an unreliable indicator of actual BP control. Automated BP monitoring is useful in identifying WCE. The utility of automated BP monitoring has seldom been part of clinical practice in developing countries. Aim: The goal of this study was to estimate the prevalence and determinants of WCE in adult patients with CKD in an outpatient setting using an automated BP device. Materials and Method: In this prospective observational study, patients with CKD attending the nephrology clinic over a period of 6 months (January 2016 to July 2016), who were suspected to have WCE by the treating physician, were assigned to measurement of BP by both the standardized manual BP recording by a single nephrologist and with automated machine as per a defined protocol. Clinical, demographic characters that would influence outcomes were also studied. Results: Among 118 patients with CKD with suspected WCE, 57.6% showed WCE. The mean systolic and diastolic BPs were significantly lower with automated machine when compared with manual BP recordings in patients with WCE (p = 0.04). WCE was seen in all stages of CKD. Occurrence of WCE in CKD was not dependent on factors such as old age, sex, diabetes mellitus, or smoking status in our study. Conclusion: WCE is a highly prevalent and underdiagnosed entity in patients with CKD. Automated machine is a useful and time-saving tool in detection of WCE in patients with CKD attending the outpatient clinic and guide management.

Original languageEnglish
Pages (from-to)448-453
Number of pages6
JournalIndian Journal of Nephrology
Volume28
Issue number6
DOIs
Publication statusPublished - 01-11-2018

Fingerprint

Chronic Renal Insufficiency
Blood Pressure
Equipment and Supplies
Nephrology
Ambulatory Care Facilities
Developing Countries
Observational Studies
Diabetes Mellitus
Outpatients
Smoking
Demography
Prospective Studies
Hypertension
Physicians

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

@article{913f902081cb45e69eb25167dbc08c0a,
title = "Prevalence and clinical correlates of white coat effect in patients with chronic kidney disease and the role of automated blood pressure device in its assessment",
abstract = "Context: Hypertension in chronic kidney disease (CKD) is an important modifiable cardiovascular risk factor. Patients with CKD can have clinically significant white coat effect (WCE), making routine clinic blood pressure (BP) measurements an unreliable indicator of actual BP control. Automated BP monitoring is useful in identifying WCE. The utility of automated BP monitoring has seldom been part of clinical practice in developing countries. Aim: The goal of this study was to estimate the prevalence and determinants of WCE in adult patients with CKD in an outpatient setting using an automated BP device. Materials and Method: In this prospective observational study, patients with CKD attending the nephrology clinic over a period of 6 months (January 2016 to July 2016), who were suspected to have WCE by the treating physician, were assigned to measurement of BP by both the standardized manual BP recording by a single nephrologist and with automated machine as per a defined protocol. Clinical, demographic characters that would influence outcomes were also studied. Results: Among 118 patients with CKD with suspected WCE, 57.6{\%} showed WCE. The mean systolic and diastolic BPs were significantly lower with automated machine when compared with manual BP recordings in patients with WCE (p = 0.04). WCE was seen in all stages of CKD. Occurrence of WCE in CKD was not dependent on factors such as old age, sex, diabetes mellitus, or smoking status in our study. Conclusion: WCE is a highly prevalent and underdiagnosed entity in patients with CKD. Automated machine is a useful and time-saving tool in detection of WCE in patients with CKD attending the outpatient clinic and guide management.",
author = "Srinivas Shenoy and Nagaraju, {Shankar Prasad} and Rau, {Nileshwar R.} and Prabhu, {Ravindra A.} and Mateti, {Uday Venkat} and Dharshan Rangaswamy and Rao, {Indu R.} and Karan Saraf",
year = "2018",
month = "11",
day = "1",
doi = "10.4103/ijn.IJN-418-17",
language = "English",
volume = "28",
pages = "448--453",
journal = "Indian Journal of Nephrology",
issn = "0971-4065",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "6",

}

Prevalence and clinical correlates of white coat effect in patients with chronic kidney disease and the role of automated blood pressure device in its assessment. / Shenoy, Srinivas; Nagaraju, Shankar Prasad; Rau, Nileshwar R.; Prabhu, Ravindra A.; Mateti, Uday Venkat; Rangaswamy, Dharshan; Rao, Indu R.; Saraf, Karan.

In: Indian Journal of Nephrology, Vol. 28, No. 6, 01.11.2018, p. 448-453.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and clinical correlates of white coat effect in patients with chronic kidney disease and the role of automated blood pressure device in its assessment

AU - Shenoy, Srinivas

AU - Nagaraju, Shankar Prasad

AU - Rau, Nileshwar R.

AU - Prabhu, Ravindra A.

AU - Mateti, Uday Venkat

AU - Rangaswamy, Dharshan

AU - Rao, Indu R.

AU - Saraf, Karan

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Context: Hypertension in chronic kidney disease (CKD) is an important modifiable cardiovascular risk factor. Patients with CKD can have clinically significant white coat effect (WCE), making routine clinic blood pressure (BP) measurements an unreliable indicator of actual BP control. Automated BP monitoring is useful in identifying WCE. The utility of automated BP monitoring has seldom been part of clinical practice in developing countries. Aim: The goal of this study was to estimate the prevalence and determinants of WCE in adult patients with CKD in an outpatient setting using an automated BP device. Materials and Method: In this prospective observational study, patients with CKD attending the nephrology clinic over a period of 6 months (January 2016 to July 2016), who were suspected to have WCE by the treating physician, were assigned to measurement of BP by both the standardized manual BP recording by a single nephrologist and with automated machine as per a defined protocol. Clinical, demographic characters that would influence outcomes were also studied. Results: Among 118 patients with CKD with suspected WCE, 57.6% showed WCE. The mean systolic and diastolic BPs were significantly lower with automated machine when compared with manual BP recordings in patients with WCE (p = 0.04). WCE was seen in all stages of CKD. Occurrence of WCE in CKD was not dependent on factors such as old age, sex, diabetes mellitus, or smoking status in our study. Conclusion: WCE is a highly prevalent and underdiagnosed entity in patients with CKD. Automated machine is a useful and time-saving tool in detection of WCE in patients with CKD attending the outpatient clinic and guide management.

AB - Context: Hypertension in chronic kidney disease (CKD) is an important modifiable cardiovascular risk factor. Patients with CKD can have clinically significant white coat effect (WCE), making routine clinic blood pressure (BP) measurements an unreliable indicator of actual BP control. Automated BP monitoring is useful in identifying WCE. The utility of automated BP monitoring has seldom been part of clinical practice in developing countries. Aim: The goal of this study was to estimate the prevalence and determinants of WCE in adult patients with CKD in an outpatient setting using an automated BP device. Materials and Method: In this prospective observational study, patients with CKD attending the nephrology clinic over a period of 6 months (January 2016 to July 2016), who were suspected to have WCE by the treating physician, were assigned to measurement of BP by both the standardized manual BP recording by a single nephrologist and with automated machine as per a defined protocol. Clinical, demographic characters that would influence outcomes were also studied. Results: Among 118 patients with CKD with suspected WCE, 57.6% showed WCE. The mean systolic and diastolic BPs were significantly lower with automated machine when compared with manual BP recordings in patients with WCE (p = 0.04). WCE was seen in all stages of CKD. Occurrence of WCE in CKD was not dependent on factors such as old age, sex, diabetes mellitus, or smoking status in our study. Conclusion: WCE is a highly prevalent and underdiagnosed entity in patients with CKD. Automated machine is a useful and time-saving tool in detection of WCE in patients with CKD attending the outpatient clinic and guide management.

UR - http://www.scopus.com/inward/record.url?scp=85058669655&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058669655&partnerID=8YFLogxK

U2 - 10.4103/ijn.IJN-418-17

DO - 10.4103/ijn.IJN-418-17

M3 - Article

AN - SCOPUS:85058669655

VL - 28

SP - 448

EP - 453

JO - Indian Journal of Nephrology

JF - Indian Journal of Nephrology

SN - 0971-4065

IS - 6

ER -