Is elevation of clinic blood pressure in patients with white coat hypertension who have normal ambulatory blood pressure associated with target organ changes?
| Autor: | P E Owens, S Lyons, SA Rodriguez, ET O'Brien |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Sympathetic nervous system Ambulatory blood pressure Heart disease Office Visits Matched-Pair Analysis Population White coat hypertension Anxiety Muscle hypertrophy Internal medicine Internal Medicine Medicine Humans education Retrospective Studies Body surface area education.field_of_study business.industry Blood Pressure Monitoring Ambulatory medicine.disease Blood pressure Endocrinology medicine.anatomical_structure Echocardiography Hypertension Female Hypertrophy Left Ventricular business |
| Zdroj: | Journal of human hypertension. 12(11) |
| ISSN: | 0950-9240 |
| Popis: | 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 < 0.001). The population was then further matched for 24-h mean BP (20 pairs), and was again compared for cardiac muscle changes. The significantly increased left ventricular mass index in the white coat population remained after controlling for 24-h mean BP (101.1 g/m 2 vs 81.0 g/m 2 , P< 0.021). 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. |
| Databáze: | OpenAIRE |
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