Can childhood white coat hypertension affect left ventricular mass?

Abstract

Abstract Background The aim of this study is to investigate whether children with white coat hypertension (WCH) have evidence of left ventricular geometrical changes. Methods A total of 237 (161 male) patients and 122 (83 male) controls with a mean age of 12.69±3.34 years were included in the study. Patients were divided into two main groups as normal weight (n=191) and obese (n=168) based on body mass index (BMI). Each group were further divided into three groups based on their blood pressure profile as hypertension (HT), WCH and control. All participant has been performed echocardiography, WCH and HT groups has been also performed ambulatory blood pressure monitoring (ABPM) and biochemical analysis. Cardiac geometry was categorized as Concentric Left Ventricular Hypertrophy [cLVH; increased left ventricular mass index (LVMI) and increased relative wall thickness (RWT)], Eccentric LVH (eLVH; increased LVMI and normal RWT), Concentric Geometry (CG; normal LVMI and increased RWT) Results In the present study, LV geometrical changes were observed as 36.2%, 22%, and 15% in the obese groups [HT/Obese (n=94), WCH/Obese (n=41), and Control/Obese (n=33), respectively, p=0.04]. However, it was 26.3%, 11.1%, and 1% in the non-obese groups [HT/Non-Obese (n=57), WCH/Non-Obese (n=45), and Control/Non-Obese (n=89), respectively, p=0.000] (Linear-by-linear association for obese 0.027 and for non-obese 0.000). Conclusion WCH can be another risk factor for cardiovascular disease. WCH can cause LV geometric changes and can be considered a pre-hypertensive intermediate state. The target-organ damage can manifest in WCH patients, especially those who are obese, or who have non-dipping BP patterns or family history