Citation: Shwan Othman Amen et al (2022). Prevalence of White Coat Hypertension amongst Patients in the Kurdistan
Region of Iraq-Erbil. Saudi J Med, 7(8): 444-450.
444
Saudi Journal of Medicine
Abbreviated Key Title: Saudi J Med
ISSN 2518-3389 (Print) | ISSN 2518-3397 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com
Original Research Article
Prevalence of White Coat Hypertension amongst Patients in the
Kurdistan Region of Iraq-Erbil
Shwan Othman Amen PhD
1
, Banan Qasim Rasool
2*
, MD. Alaa Mohammed Rashid
3
, Sara Shwan Shakir
3
, Aya nasih
Mohammad
3
, Ziad R Affas
4
, MD. Gazang Noori Abdullah
2
, Maryam Ramzi Othman
3
, Ibrahim Mohamad Chaheen
3
,
Vinwar Hameed Abdullah
3
, Heleen Araz Hussein
3
, Kosar Zeyad Rashad
3
, Bareq S. Al-Lami
3
, Rawen Hemin Akram
3
,
Baran Karwan Sulaiman
3
, Kares Abduljabbar Nooraddin
3
, Don Eliseo Lucero-Prisno III
5
1
Head of Cardiology Unit at Surgical Specialty Hospital, Cardiac Center-Erbil-Iraq, 44001
2
Kurdistan Regional Government, Ministry of Health, Erbil-Iraq, 44001
3
Hawler Medical University, College of Medicine, Erbil-Iraq, 44001
4
Department of Internal Medicine, Henry Ford Health System, Michigan, USA
5
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom,
Faculty of Management and Development Studies, University of the Philippines (Open University), Los Baños, Laguna, Philippines
DOI: 10.36348/sjm.2022.v07i08.008 | Received: 23.07.2022 | Accepted: 16.08.2022 | Published: 22.08.2022
*Corresponding Author: Banan Qasim Rasool
Kurdistan Regional Government, Ministry of Health, Erbil-Iraq, 44001
Abstract
Background: White coat hypertension (WCH) is a condition in which people exhibit an elevation in blood pressure (BP)
in a clinical setting, although they do not show such elevation in other settings. This study aims to provide new insight
into determining the prevalence of WCH amongst patients with or without any cardiovascular risk. Method: This is a
cross-sectional study of convenience sampling study design where 300 patients were involved based on their consultation
to a Tertiary Healthcare Unit between November 2021 to March 2022 in Erbil city. Patients were classified according to
the ESC into different categories of BP patterns by comparing the first BP reading that was taken at clinic with their
average AMBP readings which were taken at home. Results: A total of 300 patients were included in the study where
58% of the population was male and 42% of the population was female. Of the population, 16% had WCH, 12.3% had
sustained HTN, 59.3% were considered to be normotensive (NT), and 12.3% among them were categorized as masked
hypertension. From the total of 47 patients that were diagnosed with WCH, 55.3% were male and 44.7% were female
patients. The overall average Systolic Blood Pressure in WCH was 125.79±15.30 mmHg, and in Hypertensives it was
147.70±17.15 mm Hg with a P-value of <0.001. The Mean Arterial Pressure in WCH was 94.63±8.87 mmHg and in
Hypertensives it was 112.16±13.62 mmHg with a P-value of <0.001. The average Pulse Pressure in WCH was
75.27±9.42 mmHg, and in Hypertensives it was 76.35±9.11 mmHg with a P-value of 0.001. Conclusion: WHC is
significantly prevalent in Erbil city; therefore AMBP monitoring should be performed for those with certain indications
to limit the prescription of unnecessary long-term medications with possibly significant side effects to patients with
WHC.
Keywords: White coat hypertension (WCH), normotensive, blood pressure (BP), patients.
Copyright © 2022 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
Hypertension (HTN) is the most catastrophic
risk factor for the development of stroke and coronary
artery disease (CAD), causing significant morbidity and
mortality worldwide. It contributes to about 13.5% of
overall mortality globally [1]. Therefore an accurate and
early diagnosis of hypertension is vital in its
management [2], as well as to avoid the severe
consequences and the burden hypertension has on the
body. It is more effective to recognize the disease early
on in the population, as early management can result in
better outcomes [3]. The diagnosis of hypertension is
usually established by the use of ‘in-office’ and home
self-monitoring or ambulatory blood pressure
measurements. The use of these devices can also help
identify many conditions including white coat
hypertension [4].