Evolución de la hipertensión de bata blanca a hipertensión mantenida. Seguimiento durante un año mediante monitorización ambulatoria de la presión arterial
Evolution of white coat hypertension to sustained hypertension. One year follow-up by ambulatory blood pressure monitoring
Emilio Márquez Contrerasa,
, José Joaquín Casado Martíneza, Amalia Fernández Ortegab, Juan Javier Márquez Cabezaa
Autor para correspondencia
emarquezc@papps.org
Correspondencia: Dr. E. Márquez Contreras. Avda. Italia, 107, 5.o A. 21003 Huelva.
Correspondencia: Dr. E. Márquez Contreras. Avda. Italia, 107, 5.o A. 21003 Huelva.
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Seguimiento durante un año mediante monitorización ambulatoria de la presión arterial" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "255" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Emilio Márquez Contreras, José Joaquín Casado Martínez, Amalia Fernández Ortega, Juan Javier Márquez Cabeza" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Emilio" "apellidos" => "Márquez Contreras" "email" => array:1 [ 0 => "emarquezc@papps.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "José" "apellidos" => "Joaquín Casado Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Amalia" "apellidos" => "Fernández Ortega" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Juan" "apellidos" => "Javier Márquez Cabeza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Médicos especialistas en Medicina Familiar Comunitaria." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Enfermera. Centro de Salud La Orden. Huelva." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. E. Márquez Contreras. Avda. Italia, 107, 5.o A. 21003 Huelva." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Evolution of white coat hypertension to sustained hypertension. One year follow-up by ambulatory blood pressure monitoring" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-10-02" "fechaAceptado" => "2001-01-09" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec220847" "palabras" => array:5 [ 0 => "Hipertensión de bata blanca" 1 => "Hipertensión arterial" 2 => "Monitorización ambulatoria de la presión arterial" 3 => "Incidencia" 4 => "Estudio de cohortes" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec220848" "palabras" => array:5 [ 0 => "White coat hypertension" 1 => "Arterial hypertension" 2 => "Ambulatory blood pressure monitoring" 3 => "Incidence" 4 => "Cohorts study" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la evolución de la hipertensión de bata blanca (HBB) a hipertensión mantenida mediante monitorización ambulatoria de la presión arterial (MAPA) durante el primer año tras su diagnóstico.</p> <span class="elsevierStyleSectionTitle">Sujetos y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se diseñó un estudio prospectivo de cohortes en el centro de salud La Orden de Huelva. Se seleccionaron 86 individuos divididos en dos grupos: a) grupo de no expuestos (GNE), compuesto por 43 normotensos voluntarios, y b) grupos expuestos (GE): 43 individuos con HBB, definidos ambos grupos por presiones arteriales clínicas inferiores o superiores, respectivamente, a 140 y/o 90 mmHg y cifras de presión arterial ambulatoria diurna inferiores a 135 y 85 mmHg en ambos casos. Se realizó una MAPA (Spacelabs 90207) al inicio del estudio, a los 6 meses y al año. Se compararon entre ambos grupos las presiones arteriales clínicas y ambulatorias, así como la incidencia de hipertension arterial mantenida por MAPA. Se consideró hipertensión mantenida cuando las cifras diurnas fueron superiores a 135 y/o 85 mmHg para la presión arterial sistólica y diastólica, respectivamente.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Finalizaron el estudio 82 individuos. La incidencia de hipertensión arterial a los 6 meses de seguimiento fue del 4,76% (intervalo de confianza [IC]: 0-26,9) en GNE y del 19,04% (IC, 0-42,6) en el GE (riesgo relativo [RR]: 3,8; IC, 0,86-16,9) (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,052). Al año de seguimiento, la incidencia de hipertensión arterial en el GNE fue del 9,8% (IC, 0-31,1) frente al 46,3% (IC, 20,5-72,1) en el GE (RR: 4,63; IC, 1,7-12,4) (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,001).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los individuos con HBB presentan una incidencia de hipertensión arterial superior a los normotensos al año de seguimiento.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To analyse the evolution of the white coat hypertension (WCH) to sustained hypertension, by means of ambulatory blood pressure monitoring (ABPM) during the first year after its diagnosis.</p> <span class="elsevierStyleSectionTitle">Subjects and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A prospective study of cohorts was designed in La Orden Health Center of Huelva, Spain. 86 individuals divided in two groups: a) group not exposed (GNE): 43 voluntary normotensives, and b) group exposed (GE): 43 individuals with WCH, defined as the blood pressure was superior or above 140 and/or 90 mmHg, respectively, with a mean diurnal ABPM below 135 and 85 mmHg in both cases. A ABPM was performed (Spacelabs 90207) at the beginning of the study, after 6 months and after 12 months. The clinical and ambulatory blood pressure and the incidence of sustained hypertension by ABPM in the two groups were compared. Sustained hypertension was considered when the diurnal blood pressure was superior to 135 and/or 85 mmHg for SBP and DBP.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">At the end of the study, 82 patients were evaluate. The incidence of hypertension at 6 months of follow-up was of 4,76% (CI, 0-26.9) in GNE and 19.04% (95% CI, 0-42,6) in GE (RR: 3.8; 95% CI, 0.86-16.9) (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.052). At one year of follow-up the incidence of hypertension in GNE was of 9.8% (95% CI, 0.31-1) as opposed to 46.3% (95% CI, 20.5-72.1) in GE (RR: 4.63; CI, 1.7-12.4) (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The patients with WCH present a higher incidence of hypertension as compared to the normotensives, after 12 months of our follow-up.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How Common is coat hypertension?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.G. 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|---|---|---|---|
| 2024 Septiembre | 0 | 4 | 4 |
| 2024 Agosto | 0 | 2 | 2 |
| 2024 Julio | 0 | 1 | 1 |
| 2024 Junio | 0 | 5 | 5 |
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| 2024 Marzo | 0 | 18 | 18 |
| 2024 Febrero | 0 | 10 | 10 |
| 2024 Enero | 0 | 10 | 10 |
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| 2023 Enero | 0 | 2 | 2 |
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| 2022 Marzo | 1 | 3 | 4 |
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| 2022 Enero | 0 | 5 | 5 |
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| 2021 Noviembre | 0 | 1 | 1 |
| 2021 Octubre | 0 | 3 | 3 |
| 2021 Agosto | 0 | 7 | 7 |
| 2021 Julio | 0 | 7 | 7 |
| 2021 Junio | 0 | 2 | 2 |
| 2021 Mayo | 0 | 3 | 3 |
| 2021 Abril | 0 | 8 | 8 |
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| 2021 Febrero | 0 | 1 | 1 |
| 2021 Enero | 0 | 2 | 2 |
| 2020 Noviembre | 0 | 3 | 3 |
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| 2017 Agosto | 10 | 1 | 11 |
| 2017 Julio | 4 | 4 | 8 |
| 2017 Junio | 10 | 9 | 19 |
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| 2017 Abril | 6 | 20 | 26 |
| 2017 Marzo | 10 | 58 | 68 |
| 2017 Febrero | 15 | 3 | 18 |
| 2017 Enero | 19 | 4 | 23 |
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| 2016 Octubre | 53 | 14 | 67 |
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| 2016 Agosto | 25 | 6 | 31 |
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| 2016 Marzo | 11 | 10 | 21 |
| 2016 Febrero | 8 | 11 | 19 |
| 2016 Enero | 22 | 9 | 31 |
| 2015 Diciembre | 18 | 12 | 30 |
| 2015 Noviembre | 13 | 8 | 21 |
| 2015 Octubre | 16 | 11 | 27 |
| 2015 Septiembre | 22 | 7 | 29 |
| 2015 Agosto | 27 | 3 | 30 |
| 2015 Julio | 18 | 5 | 23 |
| 2015 Junio | 6 | 2 | 8 |
| 2015 Mayo | 7 | 10 | 17 |
| 2015 Abril | 16 | 12 | 28 |
| 2015 Marzo | 20 | 10 | 30 |
| 2015 Febrero | 12 | 8 | 20 |
| 2015 Enero | 18 | 1 | 19 |
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| 2014 Noviembre | 19 | 0 | 19 |
| 2014 Octubre | 30 | 1 | 31 |
| 2014 Septiembre | 37 | 1 | 38 |
| 2014 Agosto | 42 | 3 | 45 |
| 2014 Julio | 38 | 1 | 39 |
| 2014 Junio | 40 | 1 | 41 |
| 2014 Mayo | 25 | 3 | 28 |
| 2014 Abril | 20 | 8 | 28 |
| 2014 Marzo | 31 | 4 | 35 |
| 2014 Febrero | 25 | 0 | 25 |
| 2014 Enero | 30 | 3 | 33 |
| 2013 Diciembre | 28 | 3 | 31 |
| 2013 Noviembre | 25 | 2 | 27 |
| 2013 Octubre | 33 | 6 | 39 |
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| 2013 Agosto | 31 | 7 | 38 |
| 2013 Julio | 30 | 2 | 32 |
| 2013 Junio | 1 | 0 | 1 |
| 2013 Mayo | 1 | 0 | 1 |
| 2001 Febrero | 1305 | 0 | 1305 |
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