Arterial Stiffness in Treated Hypertensive Patients With White‐Coat Hypertension

Abstract

Arterial stiffness, assessed through pulse wave velocity (PWV), independently predicts cardiovascular outcomes. In untreated persons, white‐coat hypertension (WCH) has been related to arterial stiffness, but data in treated patients with WCH are scarce. The authors aimed to determine a possible association between WCH and arterial stiffness in this population. Adult treated hypertensive patients underwent home blood pressure monitoring and PWV assessment. Variables associated with PWV in univariable analyses were entered into a multivariable linear regression model. The study included 121 patients, 33.9% men, median age 67.9 (interquartile range 18.4) years, 5.8% with diabetes, and 3.3% with a history of cardiovascular or cerebrovascular disease. In multivariable analysis, WCH in treated hypertensive patients remained a determinant of PWV: β=1.1 (95% confidence interval, 0.1–2.1 [P=.037]; adjusted R2 0.49). In conclusion, WCH is independently associated with arterial stiffness in treated hypertensive patients. Whether this high‐risk association is offset by antihypertensive treatment should be further investigated.

Aldosterone-to-renin ratio is related to arterial stiffness when the screening criteria of primary aldosteronism are not met

“…Noteworthy, in the present study the systolic and diastolic BP values were 13–16 and 16–17 mmHg lower, respectively, during the haemodynamic laboratory measurements than in the office measurements. This resembles the white-coat effect in hypertension, which has been related to large arterial stiffness in both untreated 52 and treated hypertensive patients 53 . Out-of-office BP monitoring provides better assessment of overall BP and response to treatment in patients with white-coat hypertension 54 .…”

Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…erefore, arterial elasticity and function are used as a variety of cardiovascular risk factors for subclinical vascular lesions [8][9][10]. Recently, it has been demonstrated that arterial stiffness is another important risk factor that is independent of other cardiovascular risk factors and is considered to be an alternative endpoint of cardiovascular disease, and is associated with the morbidity and mortality of cardiovascular disease [11][12][13].…”

Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects

“…However, the present measurements performed in supine position under quiet standardized laboratory conditions did not uncover any significant differences in peripheral or central BP between the PUA quartiles. Previously, white-coat hypertension was reported to be independently associated with higher large arterial stiffness in treated hypertensive patients [ 49 ]. Furthermore, when evaluated using the ratio of pulse pressure to stroke volume, higher arterial stiffness was also significantly related to the white-coat effect in 2778 hypertensive patients [ 50 ].…”