The prevalence of silent myocardial ischaemia in patients with white-coat hypertension

Nalbantgil, İstemi; Önder, Remzi; Nalbantgil, Sanem; Yılmaz, Hasan; Boydak, Bahar

doi:10.1038/sj.jhh.1000607

Cited by 23 publications

(10 citation statements)

References 26 publications

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“…37 Incidence of SMI was observed to be 26.2% in hypertensive patients and 18.8% in white-Coat hypertension. 38 Our findings related to systolic and diastolic blood pressure did not show that there was a significant difference in diabetic patients, with or without SMI; thus, in the present study SMI was not affected by the hypertensive status of the patients.…”

Section: Discussionmentioning

confidence: 39%

Osteoprotegerin, leptin and IL-6: Association with silent myocardial ischemia in type 2 diabetes mellitus

Güzel

Seven

Kocaoğlu

et al. 2012

Diabetes and Vascular Disease Research

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Background: Diabetic patients often exhibit severe, asymptomatic coronary artery disease (CAD). The relationship between osteoprotegerin (OPG), inflammatory markers and silent myocardial ischemia remains to be elucidated. Methods: We recruited 45 type 2 diabetic patients and 33 healthy controls and assessed them for silent myocardial ischemia (SMI) by myocardial perfusion imaging. Patient blood was tested for OPG, IL-6 and leptin concentrations. Results: OPG, leptin and IL-6 levels were found significantly elevated in diabetic patients (p < 0.001, p < 0.01, p < 0.05). Based on our classification of presence/absence of SMI in our diabetic group, we found that there was a significant association between SMI and the biomarkers IL-6 (p < 0.001), leptin (p < 0.001) and OPG (p < 0.05). In multivariate regression analyses, OPG was found to be significantly related to diabetes mellitus and to SMI. Age, sex and smoking increased the association between OPG and SMI. Conclusion: High OPG, leptin and IL-6 levels are associated with the presence and severity of SMI in type 2 diabetic patients.

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Section: Discussionmentioning

confidence: 39%

Osteoprotegerin, leptin and IL-6: Association with silent myocardial ischemia in type 2 diabetes mellitus

Güzel

Seven

Kocaoğlu

et al. 2012

Diabetes and Vascular Disease Research

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“…Patients with white coat hypertension not only show greater blood pressure variability than normal control subjects, but also have a different metabolic and neuroendocrine profile 90. Some investigators reported that patients with white coat hypertension have moderately increased left atrial dimension91 and left ventricular mass,88 91disturbed diastolic function of the left ventricle91 or an increased prevalence of silent coronary ischaemia 92. On the other hand, there is mounting evidence (already discussed) that apart from the few cases misclassified at initial diagnosis, outcome is better correlated with ambulatory blood pressure measurements than with clinic readings47 68 72-76 78 and that white coat hypertension, therefore, is genuinely a benign condition.…”

Section: Diagnosis and Treatment Of White Coat Hypertensionmentioning

confidence: 99%

Modern approaches to blood pressure measurement

Staessen¹,

O’Brien²,

Thijs³

et al. 2000

Occup Environ Med

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Automated BP measurement is most useful to identify patients with white coat hypertension. Whether or not white coat hypertension predisposes to sustained hypertension remains debated. However, outcome is better correlated with the ambulatory BP than with the conventional BP. In patients with white coat hypertension, antihypertensive drugs lower the BP in the clinic, but not the ambulatory BP, and also do not improve prognosis. Ambulatory BP monitoring is also better than conventional BP measurement in assessing the eVects of treatment. Ambulatory BP monitoring is necessary to diagnose nocturnal hypertension and is especially indicated in patients with borderline hypertension, elderly patients, pregnant women, patients with treatment resistant hypertension, and also in patients with symptoms suggestive of hypotension. Conclusions-The newer techniques of BP measurement are now well established in clinical research, for diagnosis in clinical practice, and will increasingly make their appearance in occupational and environmental medicine.

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“…Nalbantgil et al [40] estimated the incidence of silent myocardial ischemia by ambulatory electrocardiographic monitoring in patients with mild-to-moderate hypertension, white-coat hypertension and those with normal blood pressure, stating that the incidence of silent ischemia was 6.4%, 18.8%, and 26.2% in cases with normal blood pressure, white-coat hypertension, and hypertension, respectively.…”

Section: Smi and Hypertensionmentioning

confidence: 98%