Gender specific profiles of white coat and masked hypertension impacts on arterial structure and function in the SardiNIA study

Abstract

Background There is no definite consensus on the CV burden associated to Masked hypertension (MH) or White Coat Hypertension (WCH) — conditions that can be detected by out-of-office blood pressure measurements (24 hour Ambulatory Blood Pressure Monitoring, 24 h ABPM). Methods We investigated the association of WCH and MH with arterial aging, indexed by a range of parameters of large artery structure and function in 2962 subjects, taking no antihypertensive medications, who are participating in a large community-based population of both men and women over a broad age range (14–102 years). Results The overall prevalence of WCH was 9.5% and was 5.0% for MH, with 54.9% of subjects classified as true normotensive and 30.6% as true hypertensive. Both WCH and MH were associated with a stiffer aorta, a less distensible and thicker common carotid artery, and greater central BP than true normotensive subjects. Notably, the profile of arterial alterations in WCH and MH did not significantly differ from what was observed in true hypertensive subjects. The arterial changes accompanying WCH and MH differed in men and women, with women showing a greater tendency towards concentric remodeling, greater parietal wall stress, and PWV than men. Conclusion Both WCH, and MH are associated with early arterial aging, and therefore, neither can be regarded as innocent conditions. Future studies are required to establish whether measurement of arterial aging parameters in subjects with WCH or MH will identify subjects at higher risk of CV events and cognitive impairment, who may require more clinical attention and pharmacological intervention.

Association of the genetic ancestry with resistant hypertension in the ReHOT (Resistant Hypertension Optimal Treatment) randomized study

“…in conclusion, increased African genetic ancestry was not associated with RH in Brazilian patients from a prospective randomized hypertension clinical trial.likely to be black 8 . Some variables, such as advanced age, increased body mass index, male gender, genetic variants and others chronic diseases were also associated with RH or uncontrolled hypertension [28][29][30][31] .On the other hand, some studies, including the present study, did not find an association of self-reported race/ color with RH. A study with 9,361 hypertensive patients from the US, did not find differences in RH proportions according to race 32 .…”

“…likely to be black 8 . Some variables, such as advanced age, increased body mass index, male gender, genetic variants and others chronic diseases were also associated with RH or uncontrolled hypertension [28][29][30][31] .…”

The effects of age on pulse wave velocity in untreated hypertension

“…The overall prevalence of masked hypertension and white‐coat hypertension in population‐based studies averaged 13% and white‐coat hypertension was about 32% among hypertensive patients . These conditions were independently associated with increases of AS …”

Lower Heart Rate Variability Is Associated with Lower Pulse Pressure Amplification: Role of Obesity

“…Measurement of central pressures was determined from radial waveforms using the validated SphygmoCor device (AtCor Medical) [17]. All measurements were made in duplicate by a single operator.…”