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White-coat hypertension during coronary computed tomography angiography is associated with higher coronary

Cátia Costa1, Pedro de Araújo Gonçalves, António Ferreira

  • 1aHospital da Luz bHospital de Santa Cruz cCEDOC, Nova Medical School, Lisbon dHospital Santarém, Santarém, Portugal.

Coronary Artery Disease
|September 1, 2016
PubMed

Insights

White-coat hypertension (WCH) is linked to increased coronary atherosclerosis, including higher coronary artery calcium (CAC) scores and plaque presence. WCH independently predicts elevated CAC, indicating a greater cardiovascular risk.

Area of Science:

  • Cardiology
  • Radiology
  • Hypertension Research

Background:

  • White-coat hypertension (WCH) is common and associated with elevated cardiovascular risk.
  • Understanding the subclinical atherosclerotic burden in WCH is crucial for risk stratification.

Purpose of the Study:

  • To evaluate the association between WCH and coronary atherosclerotic burden.
  • To assess coronary artery calcium (CAC) scoring and coronary computed tomography angiography (CCTA) findings in WCH patients.

Main Methods:

  • 1362 patients underwent CCTA and CAC scoring, categorized into normal blood pressure (BP), WCH, and hypertension groups.
  • Coronary atherosclerotic markers assessed included CAC > 50th percentile (CAC>p50), any coronary artery disease (CAD) plaque, and obstructive CAD (>50% stenosis).

Main Results:

  • WCH patients showed significantly higher CAC>p50 (30.5% vs. 19.4%), any CAD (50.6% vs. 36.8%), and obstructive CAD (13.8% vs. 8.3%) compared to normal BP.
  • Multivariate analysis identified WCH as an independent predictor of CAC>p50 (OR 1.563, P=0.041).

Conclusions:

  • WCH is associated with a greater coronary atherosclerotic burden compared to normal BP.
  • WCH independently predicts elevated coronary artery calcium (CAC>p50), suggesting increased cardiovascular risk.
Abstract

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