'White coat' hypertension. No harm for the heart

Area of Science:

• Cardiology
• Hypertension Research
• Diagnostic Monitoring

Background:

• Ambulatory blood pressure monitoring (ABPM) is superior to casual measurements for predicting organ damage.
• The clinical significance of "white coat" hypertension, characterized by higher office readings than ambulatory ones, remains debated.
• Left ventricular hypertrophy is a significant risk factor for cardiovascular events, making its relationship with hypertension crucial to understand.

Purpose of the Study:

• To investigate whether the
• white coat
• effect, defined as the difference between office and daytime blood pressure, influences left ventricular mass in essential hypertensive patients.
• To determine if elevated office blood pressure readings, independent of daytime ambulatory blood pressure, represent an added cardiovascular risk.

Main Methods:

• M-mode echocardiography was used to measure left ventricular mass indexed for height in 204 essential hypertensive patients.
• 24-hour ambulatory blood pressure monitoring (ABPM) was performed using a noninvasive device.
• Office blood pressure was measured under standardized conditions, and the
• white coat
• effect was calculated.

Main Results:

• Left ventricular mass significantly increased with higher daytime systolic blood pressure (P < .001).
• The
• white coat
• effect showed no independent influence on left ventricular mass in the overall population or in untreated patients.
• These findings held true across different quartiles of office and daytime blood pressure levels.

Conclusions:

• The
• white coat
• effect does not appear to contribute to left ventricular hypertrophy.
• White coat hypertension is likely a benign condition, not associated with increased cardiac structural changes.
• Daytime ambulatory blood pressure is the primary determinant of left ventricular mass in hypertensive individuals.