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Reverse white-coat effect as an independent risk for left ventricular concentric hypertrophy in patients with treated

M Tomiyama1, T Horio, K Kamide

  • 1Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Suita, Japan.

Journal of Human Hypertension
|December 15, 2006
PubMed

Insights

Reverse white-coat effect, where blood pressure is normal in the clinic but high outside, is linked to increased left ventricular hypertrophy in treated hypertension patients. This condition independently predicts adverse cardiac structural changes.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Reverse white-coat effect (RWCE), also known as masked hypertension, is associated with poor cardiovascular outcomes.
  • Understanding its specific impact on cardiac structure is crucial for managing hypertensive patients.

Purpose of the Study:

  • To investigate the association between RWCE and left ventricular (LV) structure in treated hypertensive patients.
  • To determine if RWCE influences LV mass index and relative wall thickness.

Main Methods:

  • Echocardiography was used to assess LV mass index and relative wall thickness in 272 treated hypertensive outpatients.
  • Patients were categorized into two groups: without RWCE (office SBP ≥ daytime SBP) and with RWCE (office SBP < daytime SBP).

Main Results:

  • LV mass index and relative wall thickness were significantly greater in patients with RWCE compared to those without.
  • A higher rate of concentric hypertrophy was observed in the RWCE group.
  • RWCE was identified as an independent predictor of LV concentric hypertrophy.

Conclusions:

  • Reverse white-coat effect is an independent risk factor for left ventricular hypertrophy, particularly concentric hypertrophy, in treated hypertensive individuals.
  • Ambulatory blood pressure, not office blood pressure, correlates with adverse LV structural changes in this population.

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