Magnitude of the white-coat effect in the community pharmacy setting: The MEPAFAR study

Sabater-Hernández, D; De La Sierra, A; Sánchez-Villegas, P; Baena, MI; Amariles, P; Faus, MJ

Magnitude of the white-coat effect in the community pharmacy setting: The MEPAFAR study

Sabater-Hernández, D

De La Sierra, A Sánchez-Villegas, P Baena, MI Amariles, P Faus, MJ

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Publication Type:: Journal Article
Citation:: American Journal of Hypertension, 2011, 24 (8), pp. 887 - 892
Issue Date:: 2011-08-01

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Field	Value	Language
dc.contributor.author	Sabater-Hernández, D https://orcid.org/0000-0001-7419-8740	en_US
dc.contributor.author	De La Sierra, A	en_US
dc.contributor.author	Sánchez-Villegas, P	en_US
dc.contributor.author	Baena, MI	en_US
dc.contributor.author	Amariles, P	en_US
dc.contributor.author	Faus, MJ	en_US
dc.date.issued	2011-08-01	en_US
dc.identifier.citation	American Journal of Hypertension, 2011, 24 (8), pp. 887 - 892	en_US
dc.identifier.issn	0895-7061	en_US
dc.identifier.uri	http://hdl.handle.net/10453/29012
dc.description.abstract	BackgroundThere is little information regarding the community pharmacy blood pressure (CPBP) measurement method and their differences with home (HBP) or ambulatory BP (ABP). The aim of this study was to measure such differences and their variation over successive visits.MethodCross-sectional study carried out in eight pharmacies in Gran Canaria (Spain). The study included 169 treated hypertensive patients. BP was measured at the pharmacy (four visits), at HBP (4 days) and 24-h ABP monitoring. We defined pharmacy white-coat effect (PWCE) as differences between CPBP and HBP (home PWCE) or daytime ABP (ambulatory PWCE).ResultsThe overall (pooled values for all visits) ambulatory PWCE was not significantly different from zero for systolic BP (SBP) (0.4mmHg (95% confidence interval (CI): 1.8 to 1.1)), but greater than zero for diastolic BP (DBP) (3.4mmHg (95% CI: 2.3 to 4.6)). The overall home PWCE was not significantly different from zero, both for SBP (1.2mmHg (95% CI: 0.1 to 2.6)) and DBP (0.1mmHg (95% CI: 0.7 to 1.0)). The ambulatory and home PWCE on the first visit were greater than zero (P <0.001) (SBP/DBP): 3.5/4.8 and 1.9/1.5mmHg, respectively; but showed important reductions at the second visit and became not significantly different from zero, except the ambulatory PWCE in DBP, which persisted until the last visit.ConclusionThe trend in the PWCE decreased over the successive visits to the pharmacy. Only the ambulatory PWCE in DBP proved to be statistically greater than zero after the second visit. Repeated CPBP measurements could be a useful alternative to assess the response to antihypertensive treatment. © 2011 American Journal of Hypertension, Ltd.	en_US
dc.relation.ispartof	American Journal of Hypertension	en_US
dc.relation.isbasedon	10.1038/ajh.2011.68	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hypertension	en_US
dc.subject.mesh	Blood Pressure Determination	en_US
dc.subject.mesh	Blood Pressure Monitoring, Ambulatory	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Pharmacies	en_US
dc.subject.mesh	Spain	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	White Coat Hypertension	en_US
dc.title	Magnitude of the white-coat effect in the community pharmacy setting: The MEPAFAR study	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	24	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	24	en_US

Abstract:

BackgroundThere is little information regarding the community pharmacy blood pressure (CPBP) measurement method and their differences with home (HBP) or ambulatory BP (ABP). The aim of this study was to measure such differences and their variation over successive visits.MethodCross-sectional study carried out in eight pharmacies in Gran Canaria (Spain). The study included 169 treated hypertensive patients. BP was measured at the pharmacy (four visits), at HBP (4 days) and 24-h ABP monitoring. We defined pharmacy white-coat effect (PWCE) as differences between CPBP and HBP (home PWCE) or daytime ABP (ambulatory PWCE).ResultsThe overall (pooled values for all visits) ambulatory PWCE was not significantly different from zero for systolic BP (SBP) (0.4mmHg (95% confidence interval (CI): 1.8 to 1.1)), but greater than zero for diastolic BP (DBP) (3.4mmHg (95% CI: 2.3 to 4.6)). The overall home PWCE was not significantly different from zero, both for SBP (1.2mmHg (95% CI: 0.1 to 2.6)) and DBP (0.1mmHg (95% CI: 0.7 to 1.0)). The ambulatory and home PWCE on the first visit were greater than zero (P <0.001) (SBP/DBP): 3.5/4.8 and 1.9/1.5mmHg, respectively; but showed important reductions at the second visit and became not significantly different from zero, except the ambulatory PWCE in DBP, which persisted until the last visit.ConclusionThe trend in the PWCE decreased over the successive visits to the pharmacy. Only the ambulatory PWCE in DBP proved to be statistically greater than zero after the second visit. Repeated CPBP measurements could be a useful alternative to assess the response to antihypertensive treatment. © 2011 American Journal of Hypertension, Ltd.

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http://hdl.handle.net/10453/29012