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Relationships between ambulatory white coat effect and left ventricular mass in arterial hypertension
Giuseppe Mulè1, Emilio Nardi, Santina Cottone
1Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Centro Ipertensione, University of Palermo, Palermo, Italy. giusemme@email.it
Insights
The white coat effect, a rise in blood pressure during medical visits, is linked to increased left ventricular mass in hypertensive patients. This suggests the white coat effect may have significant health implications.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Measurement
Background:
- Essential hypertension is a prevalent condition.
- Left ventricular mass (LVM) is an indicator of cardiac health.
- The white coat effect (WCE) is a phenomenon observed during blood pressure measurement.
Purpose of the Study:
- To investigate the association between ambulatory white coat effect (WCE) and left ventricular mass (LVM).
- To determine if WCE is an independent risk factor for cardiac structural changes.
Main Methods:
- Analysis of 296 essential hypertensive patients.
- Measurement of ambulatory blood pressure monitoring (ABPM).
- Calculation of WCE as the difference between initial and mean daytime ABPM.
- Stratification of patients based on WCE median.
- Echocardiographic assessment of LVM.
Main Results:
- Higher systolic and diastolic ambulatory WCE correlated with greater LVM.
- Multiple regression analysis confirmed a significant association between WCE and LVM.
- The findings suggest WCE is not merely a transient measurement artifact.
Conclusions:
- Ambulatory white coat effect is significantly associated with increased left ventricular mass.
- WCE may contribute to adverse cardiac remodeling in hypertensive individuals.
- Further research is warranted to explore the clinical implications of WCE.
Abstract:
The aim of our study was to analyze, in a group of 296 essential hypertensives, the relationship between left ventricular mass (LVM) and ambulatory white coat effect (WCE); that is the difference between the elevation of the first measurements of ambulatory blood pressure monitoring and the mean daytime pressure. The study population was separated into two groups according to the median of the WCE. The LVM was greater in the groups with higher systolic and diastolic ambulatory WCE. The significant association between ambulatory WCE and LVM was confirmed by the results of multiple regression analysis, suggesting that ambulatory WCE may not be an innocent phenomenon.