Assessing White Coat Hypertension Prevalence and Anxiety Levels Using Beck Anxiety Inventory: A Study in Outpatient Settings

Abstract

This study aimed to determine the prevalence of white coat hypertension (WCH) compared to home-based blood pressure (BP) measurements and assess anxiety levels among individuals with WCH using the Beck Anxiety Inventory. An observational cross-sectional study was conducted from March 2021 to April 2022 on individuals visiting the Outpatient Departments (OPDs) of Khyber Teaching Hospital, Peshawar. In-hospital and home BP recordings were performed, and anxiety levels were assessed using the Beck Anxiety Inventory. A sample size of 213 normotensive individuals was selected using a non-probability convenience sampling technique. Data were collected using structured questionnaires, analyzed using IBM SPSS version 26 and MS Excel 2019, and presented in tables and charts. Among the 213 respondents aged 14-67 years, comprising 164 (77%) males and 49 (23%) females, 22 (10.3%) exhibited BP readings above 140/90 in the OPD, indicative of WCH, while registering normal readings below 140/90 at home. The Beck anxiety index scores of these 22 individuals revealed varying degrees of anxiety, with 2 (9.1%) classified as Minimal, 6 (27.3%) as mild, 12 (54.5%) as Moderate, and 2 (9.1%) as severe anxiety. The prevalence of WCH underscores its clinical significance in predicting prehypertension, cardiovascular diseases (CVDs), and target organ damage. However, the propensity for labile BP in clinical environments may lead to misinterpretation, prompting unnecessary pharmacological interventions and exacerbating physical, mental, and financial distress for patients. Thus, widespread education on WCH among healthcare professionals and the public is crucial. Additionally, home-based BP measurements and ambulatory BP monitoring are advocated as preferred alternatives to mitigate the potential risks associated with WCH.