White coat hypertension: not so benign after all?

Chung, Irene; Lip, Gregory Y.H.

doi:10.1038/sj.jhh.1001651

Cited by 6 publications

(5 citation statements)

References 18 publications

(15 reference statements)

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“…Univariate correlation analysis, conducted in the study population with WCH, revealed that LV mass indexed for height 2 White-coat hypertension and metabolic syndrome G Mulè et al of the 24-h ambulatory BP readings, did not significantly modify the results. The same was true when BMI was replaced by waist circumference.…”

Section: Resultsmentioning

confidence: 82%

“…Labelling a subject as a WCHs implies the arbitrary identification of cutoffs of ambulatory BP, which differed markedly from author to author, ranging from 80 to 95 mm Hg for diastolic BP and from 130 to 140 mm Hg for systolic BP. 1,2 Obviously, the use of higher limits for ambulatory BP results in higher frequencies of WCH individuals with end-organ damage. However, in previous investigations, such as the HARVEST (Hypertension and Ambulatory Recording Venetia Study) 3 and the PAMELA (Pressioni Arteriose Monitorate e Loro Associazioni) 4 studies, even when lower cutoffs of ambulatory BP were used, an association between WCH and left ventricular hypertrophy was found.…”

Section: Discussionmentioning

confidence: 99%

“…1 The prognostic significance of WCH has been widely explored in the last years, but it is still a matter of debate. 1,2 Indeed, the studies that evaluated the effects of WCH on hypertensive target organ damage and on the occurrence of future cardiovascular events yielded conflicting results. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] It has long been recognized that hypertension tends to cluster with various anthropometric and metabolic abnormalities, including elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol, glucose intolerance, abdominal obesity and insulin resistance, which are the main features of the metabolic syndrome (MetS).…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

et al. 2007

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Some reports have suggested that white-coat hypertension (WCH) is associated with some features of the metabolic syndrome (MetS). These metabolic disturbances, instead of WCH per se, may potentially explain the greater extent of end-organ damage sometimes observed in WCH subjects (WCHs) when compared to normotensive individuals (NTs). The aim of the present cross-sectional study was to compare left ventricular (LV) structure and function in three groups of subjects: WCHs with MetS, WCHs without MetS and NTs. A total of 145 WCHs, 35% of whom had MetS, were enrolled. As controls, 35 NTs were also studied. In all subjects, routine blood chemistry, echocardiographic examination and 24-h ambulatory blood pressure monitoring were performed. When compared with WCHs without MetS, those with MetS showed higher LV mass indexed by height elevated by a power of 2.7 (LVMH 2.7 ) (49.6714.8 vs 38.979.8 g/m 2.7 ; Po0.0001). The same parameter was greater in WCHs without MetS than in NTs (3278 g/m 2.7 ; P ¼ 0.004). Moreover, the E-wave deceleration time was longer in WCHs with MetS than in those without it (236.2766.4 vs 200.5730.8 ms; Po0.0001). The relationship of MetS with LVMH 2.7 was confirmed in multivariate regression models. Our results seem to suggest that MetS may have a deleterious influence on LV structure and function in WCH. However, WCH, being associated with an increased LV mass, also in subjects without MetS, may not be considered as an innocuous phenomenon.

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Section: Resultsmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

et al. 2007

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“…[3][4][5] Therefore, its diagnosis and control can be deceptive if we rely on a single clinic reading. 6 Home BP predicts subsequent BP trends and is useful in the management of borderline hypertension. 7 Target organ diseases and cardiovascular events relate closely to BP measurements taken outside the clinic, particularly those obtained by ambulatory monitoring.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Automated Blood Pressure Devices used by Hypertensive Patients

Wong

Shiu²,

Hwong

et al. 2005

J R Soc Med

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SUMMARYAutomated blood pressure (BP) devices are used by many hypertensive patients in Hong Kong, with or without medical advice. At two community clinics, we invited hypertensive patients aged between 40 and 70 years who used such a device to fill in a questionnaire and to have four sets of BP measurements, automated and mercury, at two visits. Of 290 hypertensive patients 120 fulfilled the criteria, and 73 of these agreed to participate. 53 devices measured arm BP, 21 measured forearm BP. The agreement between the mercury sphygmomanometer and the automated devices was poor, with average differences of 9.5 mmHg for systolic and 9.4 mmHg for diastolic and no clear advantage for either site of measurement. As a means of screening for BP >140/ 90 mmHg the sensitivity of the automated devices was 81% and the specificity was 80%. There were large variations in how often and under what circumstances the devices had been used. One-fifth of the devices had been acquired on medical advice but only 11% of the participants were aware of the three important conditions for operating such devices.Discussion of automated devices, their role and proper use, should now be part of routine hypertensive care.

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Section: Introductionmentioning

confidence: 99%

Reliability of automated blood pressure devices used by hypertensive patients

Wong

Shiu²,

Hwong

et al. 2005

Journal of the Royal Society of Medicine

View full text Add to dashboard Cite

Automated blood pressure (BP) devices are used by many hypertensive patients in Hong Kong, with or without medical advice. At two community clinics, we invited hypertensive patients aged between 40 and 70 years who used such a device to fill in a questionnaire and to have four sets of BP measurements, automated and mercury, at two visits. Of 290 hypertensive patients 120 fulfilled the criteria, and 73 of these agreed to participate. 53 devices measured arm BP, 21 measured forearm BP. The agreement between the mercury sphygmomanometer and the automated devices was poor, with average differences of 9.5 mmHg for systolic and 9.4 mmHg for diastolic and no clear advantage for either site of measurement. As a means of screening for BP >140/90 mmHg the sensitivity of the automated devices was 81% and the specificity was 80%. There were large variations in how often and under what circumstances the devices had been used. One-fifth of the devices had been acquired on medical advice but only 11% of the participants were aware of the three important conditions for operating such devices. Discussion of automated devices, their role and proper use, should now be part of routine hypertensive care.

show abstract

White coat hypertension: not so benign after all?

Cited by 6 publications

References 18 publications

Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

Reliability of Automated Blood Pressure Devices used by Hypertensive Patients

Reliability of automated blood pressure devices used by hypertensive patients

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