White-coat hypertension and cardiovascular risk

J Cardiovasc Risk. 1995 Dec;2(6):545-9.

Abstract

Objective: To compare cardiovascular risk in white-coat hypertensives, normotensives and established hypertensives.

Methods: We studied 61 hypertensive individuals, 27 of whom were white-coat hypertensives, and 35 normotensives. All subjects underwent 24 h noninvasive blood pressure monitoring and Doppler echocardiographic examination of the heart; urine was tested for microalbuminuria and the fundi of the eyes examined for retinopathy.

Results: The 24 h as well as the day- and night-time mean systolic blood pressure (SBP) was slightly but significantly higher in white-coat hypertensives than in normotensives; no significant difference was observed in diastolic blood pressure (DBP) between these groups. In white-coat hypertensives, 24 h SBP and DBP were lower than in established hypertensives (P < 0.001). The echocardiographic study showed higher values of posterior wall thickness, left ventricular mass index (LVMI), and ventricular septum thickness (P < 0.05) in white-coat hypertensives than in normotensives; fractional shortening and ejection fraction were similar. The E:A ratio, obtained from the Doppler study, was lower in white-coat hypertensives than in normotensives (1.14 +/- 0.3 versus 1.24 +/- 0.25; P < 0.05). LVMI values were smaller in white-coat hypertensives than in established hypertensives (P < 0.05), and both ejection fraction and fractional shortening were similar in the two groups. Among white-coat hypertensives, eight out of 27 showed hypertensive retinal damage; microalbuminuria values were similar to those obtained in normotensives.

Conclusions: The results of this cross-sectional and therefore limited study lead us to hypothesize that white-coat hypertensives are at higher risk than normotensives and lower risk than established hypertensives for developing cardiovascular damage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / etiology
  • Coronary Disease / etiology*
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Humans
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Hypertension / urine
  • Male
  • Middle Aged
  • Physician-Patient Relations
  • Risk Factors
  • Stress, Psychological / physiopathology*
  • Ventricular Function, Left