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Topography and severity of coronary artery disease in white-coat hypertension

Dimitrios Kostandonis1, Vassilios Papadopoulos, Savvas Toumanidis

  • 1Department of Clinical Therapeutics, Division of Medicine, Athens University at Alexandra Hospital, GR 11527 Athens, Greece.

European Journal of Internal Medicine
|May 13, 2008
PubMed

Insights

White-coat hypertension (WCH) is linked to more severe coronary artery disease. Ultrasound of the heart and carotid arteries may help assess this risk in WCH patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • White-coat hypertension (WCH) is a known cardiovascular disease risk factor.
  • Its role in patients with suspected coronary artery disease (CAD) requires further investigation.
  • This study evaluates WCH in a cohort undergoing coronary angiography and non-invasive imaging.

Purpose of the Study:

  • To assess the severity of coronary artery disease in patients with and without white-coat hypertension.
  • To determine if non-invasive ultrasound techniques can aid in evaluating coronary artery disease in WCH patients.

Main Methods:

  • One hundred patients with suspected CAD underwent coronary angiography, 24-h ambulatory blood pressure monitoring (ABPM), and myocardial/carotid ultrasound.
  • Coronary lesions were quantified using the Gensini score (GS).
  • Patients were categorized into WCH and non-WCH groups based on blood pressure measurements.

Main Results:

  • The Gensini score was significantly higher in the WCH group (P=0.042), particularly due to left anterior descending (LAD) lesions (P=0.007).
  • In the WCH group, GS correlated with left ventricular dimensions (LVEDD, LVESD, EDV, ESV), LvMass/BSA, and carotid intima-media thickness (RICA, LICA, MICA).
  • These correlations were not observed in normotensive patients.

Conclusions:

  • Coronary artery disease may be more severe in patients with white-coat hypertension.
  • Myocardial and carotid ultrasound data may assist in estimating coronary artery disease severity within the WCH population.
Abstract

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