Relationship of dysregulation of glucose metabolism with white-coat hypertension: the Ohasama study

Miki, Hirokazu; Mimura, Akira; Asayama, Kei; Hayashi, Kenjiro; Kikuya, Masahiro; Sato, Mariko; Hashimoto, Takanao; Kanno, Atsuhiro; Hara, Azusa; Obara, Taku; Metoki, Hirohito; Inoue, Ryusuke; Hoshi, Hiroyuki; Satoh, Hiroshi; Oka, Yoshitomo; Imai, Yutaka

doi:10.1038/hr.2010.114

Cited by 11 publications

(11 citation statements)

References 44 publications

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“…These findings suggest that WCHT is associated with glucose dysregulation and an increased risk for diabetes [18,19] . Therefore, WCHT is an initial sign of deteriorating health.…”

Section: Metabolic Syndromementioning

confidence: 75%

Closer look at white-coat hypertension

Sipahioğlu

2014

WJM

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This review aims to clarify novel concepts regarding the clinical and laboratory aspects of white-coat hypertension (WCHT). Recent studies on the clinical and biological implications of WCHT were compared with existing knowledge. Studies were included if the WCHT patients were defined according to the 2013 European Society of Hypertension guidelines, i.e., an office blood pressure (BP) of ≥ 140/90 mmHg, a home BP of ≤ 135/85 mmHg, and a mean 24-h ambulatory BP of ≤ 130/80 mmHg. WCHT studies published since 2000 were selected, although a few studies performed before 2000 were used for comparative purposes. True WCHT was defined as normal ABPM and home BP readings, and partial WCHT was defined as an abnormality in one of these two readings. The reported prevalence of WCHT was 15%-45%. The incidence of WCHT tended to be higher in females and in non-smokers. Compared with normotensive (NT) patients, WCHT was associated with a higher left ventricular mass index, higher lipid levels, impaired fasting glucose, and decreased arterial compliance. The circadian rhythm in WCHT patients was more variable than in NT patient's, with a higher pulse pressure and non-dipping characteristics. Compared with sustained hypertension patients, WCHT patients have a better 10-year prognosis; compared with NT patients, WCHT patients have a similar stroke risk, but receive more frequent drug treatment. There are conflicting results regarding WCHT and markers of endothelial damage, oxidative stress and inflammation, and the data imply that WCHT patients may have a worse prognosis. Nitric oxide levels are lower, and oxidative stress parameters are higher in WCHT patients than in NT patients, whereas the antioxidant capacity is lower in WCHT patients than in NT patients. Clinicians should be aware of the risk factors associated with WCHT and patients should be closely monitored especially to identify target organ damage and metabolic syndrome. Key words: White-coat hypertension; Ambulatory blood pressure; Target organ damage; Glucose dysregulation Core tip: There is contradictory information regarding the clinical presentations and prognosis of white-coat hypertension (WCHT). This review aims to summarize recent research and compare it to existing knowledge about WCHT. Published studies on the prevalence of WCHT, the associated target organ damage and cardiovascular markers, and WCHT patient prognosis were reviewed. WCHT may be a marker of future obesity and metabolic syndrome, is related to glucose dysregulation and left ventricular hypertrophy and may progress to sustained hypertension. Clinicians should be aware of the risk factors associated with WCHT, and patients should be closely monitored, especially to identify target organ damage and metabolic syndrome.Sipahioglu NT, Sipahioglu F. Closer look at white-coat hypertension. World

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“…These findings suggest that WCHT is associated with glucose dysregulation and an increased risk for diabetes [18,19] . Therefore, WCHT is an initial sign of deteriorating health.…”

Section: Metabolic Syndromementioning

confidence: 75%

Closer look at white-coat hypertension

Sipahioğlu

2014

WJM

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“…The prevalence of impaired glucose tolerance was 24.4% and 17.2% in the WCHT and normotensives, respectively, whereas the prevalence of diabetes was 8.9% and 3.7% normotensives, respectively. 13 A link between impaired glucose tolerance and WCHT was also found in a study of 105 subjects who were aged 39-75 years, untreated, non-smokers and with normal fasting glucose levels. 14 Mean 2 h plasma glucose level post-load, adjusted for age and waist circumference, was 5.7 mmol/L in normotensives and 7.4 mmol/L in the WCHT group (P = 0.002).…”

Section: Is White-coat Hypertension Associated With Metabolic Syndrome?mentioning

confidence: 75%

“…The prevalence of impaired fasting glucose was 11.1% and 2.2% in the WCHT and normotensives, respectively. The prevalence of impaired glucose tolerance was 24.4% and 17.2% in the WCHT and normotensives, respectively, whereas the prevalence of diabetes was 8.9% and 3.7% normotensives, respectively …”

Section: Is White‐coat Hypertension Associated With Metabolic Syndrome?mentioning

confidence: 91%

White-coat hypertension

Martin

McGrath

2013

Clin Exp Pharmacol Physiol

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1. Numerous studies have examined whether white-coat hypertension (WCHT) is associated with increased cardiovascular risk, but with definitions of WCHT that were not sufficiently robust, results have been inconsistent. The aim of the present review was to standardize the evidence by only including studies that used a definition of WCHT consistent with international guidelines. 2. Published studies were reviewed for data on vascular dysfunction, target organ damage, risk of future sustained hypertension and cardiovascular events. 3. White-coat hypertension has a population prevalence of approximately 15% and is associated with non-smoking and slightly elevated clinic blood pressure. Compared with normotensives, subjects with WCHT are at increased cardiovascular risk due to a higher prevalence of glucose dysregulation, increased left ventricular mass index and increased risk of future diabetes and hypertension. 4. In conclusion, management of a patient with WCHT should focus on cardiovascular risk factors, particularly glucose intolerance, not blood pressure alone.

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“…It was reported that WCH was accompanied by a greater proportion of other cardiovascular risk factors, such as impaired glucose metabolism, high BMI, and dyslipidemia [27,29,30], which were also known as risk factors for CVD. In our study, most of the included studies were adequately adjusted for these risk factors.…”

Section: Discussionmentioning

confidence: 99%