The deep-breath test as a diagnostic maneuver for white-coat effect in hypertensive patients

AUGUSTOVSKI, F. A.; CALVO, C. B.; DEPRATI, M.; WAISMAN, G.

The Journal of the American Board of Family Practice / American Board of Family Practice

J Am Board Fam Pract

Año: 2004 p. 1 - 30

0893-8652

BACKGROUND: The white-coat effect is a common phenomenon in hypertensive patients, and there is no current useful office test to detect it. METHODS: This was a cross-sectional study. We evaluated the deep-breath maneuver at the office as a diagnostic test of the white-coat effect. Participants included 83 adult patients with uncontrolled office hypertension. We measured sensitivity, specificity, likelihood ratios of different cutoff points, area under receiver operating characteristic (ROC) curve, and 95% confidence intervals. The reference standard used was 24-hour ambulatory blood pressure monitoring. RESULTS: We included 73 patients [mean age, 58.7 +/- 9.5 years (mean +/- SD); 55% women]. The prevalence of white-coat effect was 62%. Comparing patients with white-coat effect versus those without, the deep-breath test resulted in a mean systolic blood pressure decrease of 17.8 and 10.9 mm Hg (P