Effect of masked, white-coat, and sustained hypertension on coronary flow reserve and peripheral endothelial...

Area of Science:

• Cardiology
• Hypertension Research
• Vascular Physiology

Background:

• Masked hypertension (MH) presents a diagnostic challenge, potentially leading to underestimation of cardiovascular risk.
• Sustained hypertension (SH) is a well-established risk factor for cardiovascular events.
• White-coat hypertension (WCH) is characterized by elevated blood pressure in clinical settings but normal readings outside.

Purpose of the Study:

• To compare coronary flow reserve (CFR) and brachial artery flow-mediated dilatation (FMD) across different hypertension phenotypes.
• To assess subclinical cardiac and vascular dysfunction in masked hypertension.
• To evaluate the relationship between hypertension types and cardiovascular risk markers.

Main Methods:

• Transthoracic echocardiography to measure CFR.
• Vascular ultrasound to assess brachial artery FMD.
• Comparative analysis of CFR and FMD in subjects with MH, SH, WCH, and healthy controls.

Main Results:

• CFR was significantly lower in MH (2.30 ± 0.39) and SH (2.28 ± 0.52) groups compared to WCH (2.77 ± 0.41) and control (2.85 ± 0.39) groups (P < .05).
• Impaired CFR was observed in MH and SH patients relative to WCH and normotensive subjects.
• MH and SH groups exhibited comparable cardiovascular risks and target organ damage.

Conclusions:

• Masked hypertension is associated with impaired coronary flow reserve, similar to sustained hypertension.
• CFR may serve as an indicator of subclinical cardiac dysfunction in masked hypertension.
• These findings underscore the importance of identifying and managing masked hypertension to mitigate cardiovascular risk.