Target Organ Status and Serum Lipids in Patients With White Coat Hypertension

Pierdomenico, Sante D.; Lapenna, Domenico; Guglielmi, Maria Domenica; Antidormi, Teresa; Schiavone, Cosima; Cuccurullo, Franco; Mezzetti, Andrea

doi:10.1161/01.hyp.26.5.801

Cited by 112 publications

(77 citation statements)

References 49 publications

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“…13 If this was the case, then one would expect that differences between normo-and white coat hypertensives with regard to target organ changes would disappear when the groups are further controlled for 24-h BP. Indeed, two such studies, 9,10 comparing left ventricular mass between normotensive and WCH groups, where 24-h BP was comparable across the two groups, showed no difference in structural heart changes. On the other hand, Glen et al 3 in a similarly designed study, with BP equivalence between the normal and WCH groups, showed evidence of functional cardiac derangement in the WCH group.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies looking at evidence of target organ damage have given equivocal results; left ventricular hypertrophy and renal dysfunction have both been described as occurring in association with WCH, [3][4][5][6][7][8] while other studies have not documented an association. [9][10][11][12] These studies have largely shown significantly higher mean BP in the WCH group, and it may be that the documented elevation of cardiac and renal indices of end-organ involvement found Conclusion: White coat hypertension is indeed associated with a larger left ventricular muscle mass than normotensives and these changes are independent of the actual 24-h BP load, and may reflect increased BP lability, sympathetic nervous system derangement, or a genetic propensity in people with white coat hypertension to stress-related hypertensive reactions, as part of a pre-hypertensive state.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is elevation of clinic blood pressure in patients with white coat hypertension who have normal ambulatory blood pressure associated with target organ changes?

et al. 1998

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Background:The issue as to whether white coat hypertension is a pathologically significant entity, with associated target organ changes, or that the condition carries the same risk for target organ involvement as normotension, is undecided. Previous studies which have shown pathological correlates between white coat hypertension and target organ damage have not controlled for the most obvious confounder, mean 24 h blood pressure (BP). Methods and results: In this study we retrospectively identified 33 age and sex-matched pairs, one group with normal BP, the other with white coat hypertension. The white coat hypertensive group showed significantly greater left ventricular mass indexed for body surface area than normal controls (99.0 g/m 2 vs 78.3 g/m 2 , P Ͻ

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is elevation of clinic blood pressure in patients with white coat hypertension who have normal ambulatory blood pressure associated with target organ changes?

et al. 1998

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“…Many, but not all, of these studies have demonstrated increased LVMI in WCH subjects, with LVMI intermediate between that of subjects with normotension and those with sustained hypertension. [2][3][4][5][6][7][8][9][10][11][12][13] In addition, a recent study suggests that the long-term incidence of stroke may be elevated in adults with WCH. 14 Little is known about the clinical significance and natural history of WCH in children.…”

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confidence: 99%

Left Ventricular Mass Index in Children with White Coat Hypertension

Lande

Meagher

Fisher

et al. 2008

The Journal of Pediatrics

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Objective-To determine if children with white coat hypertension (WCH) have evidence of targetorgan damage by comparing left ventricular mass index (LVMI) of subjects with WCH to that of matched normotensive and hypertensive controls.Study design-Each WCH subject was matched by body mass index (± 10%), age (± 1 year), and sex to a normotensive control and to a hypertensive control. Echocardiograms were reviewed to determine LVMI for each subject. These triple matches were analyzed using repeated measures analysis of variance to detect differences in LVMI between the three groups.Results-Twenty-seven matched triplets were established. The groups were comparable for sex, age, and body mass index (BMI). Mean LVMI was 29.2, 32.3, and 35.1 g/m 2.7 , for normotensives, WCH, and sustained hypertensives, respectively (normotensive vs. WCH, p = 0.028; WCH vs. sustained hypertensive, p = 0.07). Left ventricular hypertrophy was not present in any subject in the normotensive or WCH groups, but was present in 26% of the sustained hypertensive subjects (p < 0.001).Conclusions-After controlling closely for BMI, children with WCH had a LVMI which was intermediate between that of normotensives and sustained hypertensives, suggesting that WCH may be associated with hypertensive end-organ effects.White coat hypertension (WCH) occurs when blood pressure is elevated in the medical office but is normal outside the office setting. In adults, there is concern that WCH may be an independent risk factor for cardiovascular disease or that it may represent a prehypertensive state, with increased risk of progression to sustained hypertension. 1 Numerous adult studies have evaluated left ventricular mass index (LVMI) in subjects with WCH. Many, but not all, Corresponding Author: Marc B. Lande, MD, 601 Elmwood Ave, Box 777, Rochester, NY 14642, Phone: 585-275-9784, Fax: 585-756-8054, Email: marc_lande@urmc.rochester.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The objective of the current study was to determine if children with WCH have evidence of hypertensive target-organ effects by comparing LVMI in children with WCH, normotension, and sustained hypertension, closely matching subjects for BMI, sex, and age. NIH Public Access MethodsThe study was performed at the University of Rochester Medical Center in Rochester, NY. At this center, ABPM has been used in the evaluation of pediatric primary hypertension since October 2002. The clinical purpose of ABPM has been primarily to differentiate between sustained hypertension and white coat hypertension. It has been our practice to obtain ech...

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“…[5][6][7][8][9][10] The lack of an agreed definition for WCH further adds to the confusion. Furthermore, interpretation of these studies has been made more difficult as many are not controlled for the level of ambulatory BP.…”

Section: Association With Target Organ Damagementioning

confidence: 99%