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Cardiac and carotid structure in patients with established hypertension and white-coat hypertension

C Cuspidi1, M Marabini, L Lonati

  • 1Institute for General and Therapeutic Medicine, University of Milan and Maggiore Hospital, Italy.

Journal of Hypertension
|December 1, 1995
PubMed

Insights

White-coat hypertension shows less cardiac and vascular involvement than established hypertension. This study found significantly lower left ventricular mass and intima-media thickness in white-coat hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Ambulatory blood pressure monitoring identified white-coat hypertension, a subgroup with less cardiac involvement.
  • Previous reports suggest white-coat hypertensives experience reduced cardiac impact compared to established hypertensive patients.

Purpose of the Study:

  • To assess the extent of cardiac and vascular involvement in white-coat hypertension versus established hypertension.
  • To compare left ventricular mass and carotid artery intima-media thickness between these hypertensive groups.

Main Methods:

  • Eighty-two patients with mild essential hypertension underwent 24-hour ambulatory blood pressure monitoring.
  • Echocardiography and vascular ultrasonography were used to measure left ventricular dimensions, mass, and carotid intima-media thickness.

Main Results:

  • White-coat hypertensives (31 patients) had lower 24-hour blood pressure than established hypertensives (51 patients).
  • Established hypertensives showed significantly higher left ventricular mass index (112 vs. 98 g/m2) and intima-media thickness (0.67 vs. 0.58 mm).
  • Prevalence of left ventricular hypertrophy was higher in established hypertensives (51%) compared to white-coat hypertensives (19%).

Conclusions:

  • Structural changes in the left ventricle are more limited in white-coat hypertensives than in established hypertensives.
  • White-coat hypertensives exhibit significantly less involvement of conductance vessels compared to established hypertensive patients.
Abstract

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