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Nighttime mean arterial pressure is associated with left ventricular hypertrophy in white-coat hypertension

Xiangyu Yang1, Yuan Yuan1, Qiling Gou2

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Journal of Clinical Hypertension (Greenwich, Conn.)
|July 6, 2022
PubMed

Insights

White-coat hypertension (WCH) is linked to higher left ventricular hypertrophy (LVH) rates. Elevated nighttime mean arterial pressure and office systolic blood pressure are key factors in LVH development for WCH patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Diagnostics

Background:

  • White-coat hypertension (WCH), characterized by elevated clinic blood pressure (BP) and normal out-of-office BP, is associated with increased cardiovascular risks.
  • Left ventricular hypertrophy (LVH) is a significant indicator of cardiac damage and a predictor of adverse cardiovascular events.

Purpose of the Study:

  • To investigate the relationship between WCH and LVH.
  • To compare the prevalence of LVH in WCH patients versus true normotensive individuals.
  • To identify specific BP parameters associated with LVH in both WCH and normotensive populations.

Main Methods:

  • Recruited 706 participants for anthropometric measurements, laboratory analysis, 24-hour ambulatory blood pressure monitoring (ABPM), and echocardiography.
  • Defined WCH as elevated office BP with normal ABPM across 24-hour, daytime, and nighttime periods.
  • Compared LVH proportions and analyzed associations between BP indices and LVH using logistic regression.

Main Results:

  • The proportion of LVH was significantly higher in the WCH group (19.70%) compared to normotensive (NT) participants (13.12%).
  • In NT individuals, 24-hour SBP and daytime SBP were associated with LVH.
  • In WCH patients, nighttime mean arterial pressure (MAP) and office systolic blood pressure (SBP) were significantly associated with LVH after multivariable adjustment.

Conclusions:

  • WCH is associated with a higher prevalence of left ventricular hypertrophy compared to normotension.
  • Elevated nighttime MAP and office SBP are critical factors in the development of LVH in patients with WCH.
  • These findings highlight the importance of monitoring out-of-office BP and specific BP parameters in managing WCH patients to prevent cardiac remodeling.

Keywords:
ambulatory blood pressure monitoringechocardiographyleft ventricular hypertrophynighttime blood pressurewhite-coat hypertension

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