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Target organ damage and changes in arterial compliance in white coat hypertension. Is white coat innocent?

Y Karter1, A Curgunlu, S Altinişik

  • 1Department of Internal Medicine, Cerrahpaşa Medical Faculty, Istanbul University, Turkey. yesarikarter@yahoo.com

Blood Pressure
|February 7, 2004
PubMed

Insights

White coat hypertension (WCH) patients show intermediate target organ damage and cardiovascular risk between normotensive and sustained hypertensive individuals. These findings highlight WCH as a distinct clinical entity requiring further investigation for risk stratification.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • White coat hypertension (WCH) is characterized by elevated blood pressure in a clinical setting but normal readings outside of it.
  • Understanding the subclinical target organ damage and metabolic profile in WCH is crucial for cardiovascular risk assessment.

Purpose of the Study:

  • To comprehensively evaluate target organ status, metabolic abnormalities, and hemodynamic alterations in individuals with white coat hypertension.
  • To compare these parameters between normotensive (NT), WCH, and sustained hypertensive (HT) subjects.

Main Methods:

  • Inclusion of 50 NT, 90 WCH, and 101 HT subjects for extensive biochemical, echocardiographic, and fundoscopic examinations.
  • Subgroup analysis involving Doppler ultrasound to measure arterial compliance and intima-media thickness (IMT) of the left common carotid artery.
  • Assessment of body mass index (BMI), left ventricle mass index (LVMI), hypertensive retinopathy, urinary albumin excretion (UAE), total cholesterol, distensibility coefficient (DC), and compliance coefficient (CC).

Main Results:

  • WCH subjects exhibited higher BMI and LVMI compared to NTs, but lower than HTs.
  • Hypertensive retinopathy was present in WCH patients, though less severe and frequent than in HTs.
  • Arterial compliance (DC and CC) was reduced in WCH compared to NTs, while IMT was significantly higher in HTs than in both WCH and NTs.

Conclusions:

  • White coat hypertension patients represent an intermediate group concerning target organ damage and cardiovascular risk.
  • WCH is associated with metabolic and hemodynamic alterations, positioning it between normotension and sustained hypertension.
  • These findings underscore the importance of recognizing WCH as a distinct condition with potential long-term cardiovascular implications.

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