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Isolated clinic hypertension is not an innocent phenomenon: effect on the carotid artery structure
N Zakopoulos1, C Papamichael, H Papaconstantinou
1Athens University, Department of Clinical Therapeutics, Greece.
Insights
Isolated clinic hypertension, characterized by high blood pressure readings only in a doctor's office, shows similar arterial wall thickening as sustained hypertension. This suggests isolated clinic hypertension is not a benign condition and warrants attention.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Elevated blood pressure (BP) is a major risk factor for cardiovascular disease.
- Isolated clinic hypertension (ICH) presents with high BP in a clinical setting but normal readings outside.
- The clinical significance and vascular impact of ICH remain under investigation.
Purpose of the Study:
- To compare common carotid intimal-medial thickness (CCA-IMT) in patients with ICH, sustained hypertension, and normotension.
- To assess whether ICH is associated with subclinical vascular changes similar to sustained hypertension.
Main Methods:
- Cross-sectional study comparing three groups: ICH (n=22), sustained hypertensives (n=41), and normotensives (n=17).
- Measurements included clinic BP, 24-hour ambulatory BP monitoring, and CCA-IMT.
- Statistical analysis (one-way ANOVA) was used to compare CCA-IMT between groups.
Main Results:
- CCA-IMT was significantly higher in both the sustained hypertension group (0.67 ± 0.18 mm) and the ICH group (0.68 ± 0.14 mm) compared to the normotensive group (0.50 ± 0.09 mm).
- No significant difference in CCA-IMT was observed between the sustained hypertension and ICH groups.
- CCA-IMT did not correlate with clinic BP or 24-hour ambulatory BP monitoring values.
Conclusions:
- Subclinical changes in CCA-IMT are comparable between isolated clinic hypertension and sustained hypertension.
- These findings indicate that isolated clinic hypertension may represent a significant cardiovascular risk, similar to sustained hypertension.
- Further research and clinical monitoring are warranted for individuals with isolated clinic hypertension.
Abstract:
This study examines the common carotid intimal-medial wall thickness (CCA-IMT) in untreated patients with elevated clinic blood pressure (BP) but normal ambulatory BP (isolated clinic hypertension, n = 22), in comparison with a group with elevated clinic and ambulatory BP (hypertensives, n = 41) and a group with normal clinic and ambulatory BP (normotensives, n = 17) readings. The three groups did not differ in age, male/female ratio, lipid profile, glucose tolerance test, or smoking habits. No difference existed in CCA-IMT values between the groups with hypertension (0.67 +/- 0.18 mm) and isolated clinic hypertension (0.68 +/- 0.14 mm), but the values in these two groups were significantly higher (one-way ANOVA; F = 8.09, P < .001) than in the group of normotensives (0.50 +/- 0.09 mm). The CCA-IMT did not correlate with clinic systolic or diastolic BP readings or with BP derivatives of 24-h ambulatory monitoring. Mean 24-h BP in the isolated clinic hypertensives did not differ from that in the normotensives, whereas both were lower than in the hypertensives. We conclude that changes in the CCA-IMT occuring in subjects with isolated clinic hypertension are equal to the changes in sustained hypertension, indicating that isolated clinic hypertension may not be a benign condition.