Prevalencia de hipertensión de bata blanca durante la perimenopausia

Fundament: the decrease in oestrogenic hormones during the perimenopause increases the susceptibility to stress, therefore a higher prevalence of white coat hypertension (WCH) is probable during this period of life. Objectives: to find the prevalence of white coat hypertension during perimenopause is the principal objective. Secondary goals are: to find the frequency of climateric symptoms, toxic habits and hormone replacement therapy (HRT) during perimenopause. Design: transversal study during a period of 17 months. Setting: Health Care Centre "V Centenario " in San Sebastian de los Reyes, Madrid. Subjects: all women between 40 and 55 years that had appointments in the Health Centre. Women that were in hormone replacement therapy and those whose last period happened over 3 years before the trail, were excluded. Measurements: a personal interview with women that came to the centre as interested volunteers or after having booked an appointment over the phone, was carried out. Their height, weight and blood pressure on both arms, in the best conditions and according to international norms, were measured. If the first measurement was ≥ 140 mm Hg for the sistolic blood pressure and/or > 90 mm Hg for the diastolic blood pressure, a triple measurement was taken. When the average of the three measurements was ≥ 140/90 mm Hg they were diagnosed with clinical hypertension. In this case a 24-hour ambulatory blood pressure (ABP) monitor was placed on them. The 24-hour ABP abnormal limits have been > 140/88 mm Hg and 125/76 mm Hg for day time and night time measurements, respectively. Results and conclusions: from an initial sample of 579 women, only 321 passed the required criteria and were included in the study, resulting in a loss of 27,2%. Of the 33 new cases of clinical hypertension found from this study, 22 women (66, 6%) showed WCH. Women with WCH had a BMI larger than normal women. The prevalence of white coat hypertension is larger than in other studies with similar diagnostic criteria of clinical hypertension and 24-hour ABP, but having been carried out in different populations they are not directly comparable. In the view oh these results, it is sensible to rule out white coat hypertension from any arterial hypertension diagnosed during the perimenopause.