Affiliation:
1. From the Department of Medicine, The New York Hospital–Cornell Medical Center, New York (M.J.R., T.G.P., R.B.D.); the Institute of Gerontology and Geriatrics, University of Firenze (Italy) (M.C.C., R.P.); and the Department of Psychiatry and Behavioral Science, State University of New York–Stony Brook (J.E.S.).
Abstract
Abstract
Although white coat hypertension may be present in 20% or more of hypertensive individuals, its prognostic significance is unknown. We compared prognostically relevant measures of target-organ damage among 24 individuals with white coat hypertension and age- and sex-matched groups of sustained hypertensive and normotensive subjects classified by clinical and 24-hour ambulatory blood pressures. Left ventricular and carotid artery structure and function were evaluated by ultrasonography. Left ventricular mass index was similar in white coat hypertensive (82±17 g/m
2
) and normotensive (78±15 g/m
2
) subjects but was higher in sustained hypertensive subjects (97±19 g/m
2
,
P
<.02 and
P
<.002, respectively). Similarly, carotid artery intimal-medial thickness was greater in the sustained hypertensive group (0.98±0.21 mm) than in the white coat hypertensive (0.84±0.16 mm,
P
<.05) and normotensive (0.76±0.18 mm,
P
<.001) groups. The prevalence of discrete atherosclerotic plaques was higher in the sustained hypertensive group (58%) than in the white coat hypertensive (25%,
P
<.05) and normotensive (21%,
P
<.02) groups. Cardiac and carotid structure in individuals with white coat hypertension resemble findings in normotensive subjects and differ significantly from those in age- and sex-matched sustained hypertensive subjects. These findings suggest that white coat hypertension may be a benign condition for which pharmacological intervention may not be necessary, a hypothesis that needs to be tested in longitudinal studies with clinical end points.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
127 articles.
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