Cardiac Damage in Hypertensive Patients with Inverse White Coat Hypertension. Hospitalet Study

Background: Few studies have assessed the relationship between ambulatory blood pressure (BP) and cardiac damage in essential hypertensive patients with inverse white coat hypertension (IWCH). Objectives: To determine the frequency of IWCH in untreated grade 1-2 hypertension and to assess possible d...

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Bibliographic Details
Published in:Blood pressure 2003, Vol.12 (2), p.89-96
Main Authors: HERNÁNDEZ DEL-REY, RAQUEL, ARMARIO, PEDRO, MARTÍN-BARANERA, MONTSERRAT, SÁ, NCHEZ, PILAR, ALMENDROS, MARI CRUZ, COCA, ANTONIO, PARDELL, HELIOS
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Albuminuria - metabolism
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure Monitoring, Ambulatory
Cardiology. Vascular system
Cardiovascular Risk
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Echocardiography
Female
Humans
Hypertension - diagnosis
Hypertension - pathology
Hypertension - psychology
Inverse White Coat Hypertension
Left Ventricular Mass
Linear Models
Male
Medical sciences
Middle Aged
Myocardium - pathology
Target-organ Damage
Ventricular Function, Left - physiology
White Coat Hypertension
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Summary:Background: Few studies have assessed the relationship between ambulatory blood pressure (BP) and cardiac damage in essential hypertensive patients with inverse white coat hypertension (IWCH). Objectives: To determine the frequency of IWCH in untreated grade 1-2 hypertension and to assess possible differences in cardiac damage among patients with IWCH, white coat hypertension (WCH) and the rest of patients with grade 1-2 hypertension. Patients and Methods: Two hundred and eleven patients with grade 1-2 hypertension were sequentially included. A good quality 24-h ambulatory BP monitoring was obtained in 204 patients (age: 41 ± 12 years, 56% males). IWCH was defined as a daytime systolic and/or diastolic BP higher than diagnostic office systolic and/or diastolic BP, respectively. WCH was defined as a daytime BP < 135/85 mmHg. A good quality echocardiogram was obtained in 174 patients. We considered left ventricular hypertrophy a left ventricular mass index (LVMI) ≥ 125 g/m2. Results: We found IWCH in 29 subjects (14%), and WCH in 68 (33%). Office BP in patients with IWCH was in an intermediate position between WCH and the rest of grade 1-2 hypertension patients. The IWCH patients showed 24-h, daytime and night-time BP higher than the other groups. Left ventricular mass was significantly greater in patients with IWCH than in the other grade 1-2 hypertension patients after adjusting for age, gender, body mass index, smoking and office BP (regression coefficient 28.14, 95%CI: 7.36-48.91). Conclusion: IWCH is independently associated with higher values of left ventricular mass in patients with grade 1-2 hypertension.
ISSN:0803-7051
1651-1999
DOI:10.1080/08037050310001066