open access

Vol 9, No 1 (2005)
Prace oryginalne
Published online: 2005-02-04
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Aortic compliance, blood pressure pattern and target organ damage in young patients with white-coat hypertension

Beata Krasińska, Andrzej Tykarski, Olga Trojnarska
Nadciśnienie tętnicze 2005;9(1):45-54.

open access

Vol 9, No 1 (2005)
Prace oryginalne
Published online: 2005-02-04

Abstract

Background It is suggested that patients with white-coat hypertension have increased risk of cardiovascular complications. Impaired aortic compliance and increased left ventricular mass are independent cardiovascular risk factors in hyperttensive patients. Evaluation of these parameters in patients with white-coat hypertension may answer the question if these patients are of high cardiovascular risk and should be treated with antihypertensive drugs. The aim of the study was to compare aortic compliance, blood pressure profile, left ventricular mass index and renal hemodynamic parameters in young patients with "true" hypertension, white-coat hypertension and normal blood pressure.
Material and methods Eighty patients with initial diagnosis of arterial hypertension and 30 normotensives (group N), aged 19–40 years, were studied.
The following procedures were performed: clinic blood pressure with sphygmomanometer and 24-hour automatic blood pressure monitoring (ABPM), the estimation of aortic PWV, left ventricular mass index (LVMI) and renal hemodynamic parameters. Based on ABPM patients were divided as having "true" hypertension (group H) and white-coat hypertension (group NBF). The patients were also divided on subgroups according to PWV: HC+ (PWV < 9.2 m/s) i HC– (PWV > 9.2 m/s).
Results Mean pulse pressure was 51.6 ± 7.4 mm Hg in group H and was significantly higher (p < 0,001) than in group N (41.9 ± 5.7 mm Hg) and NBF (42.2 ± 10.2 mm Hg).
Mean PWV was lower in group N (8.24 ± 1.0 m/s) in comparison with group H (10.38 ± 2.5 m/s) i group NBF (10.48 ± 2.1 m/s) (p < 0.001). PWV did not differ between group H and NBF. Mean LVMI was 114.1 ± 10.4 g/m2 in group H, 94.0 ± 9.6 g/m2 in group N and 98.5 ± 7.7 g/m2 in group NBF. LVMI was significantly higher and renal plasma flow was significantly lower in "true" hypertensives in comparison with normotensives and patients with white coat hypertension. Strong correlations were found between pulse pressure and PWV and LVMI. No difference was found in pulse pressure, LVMI and renal parameters between patients with white-coat hypertension and impaired aortic compliance in comparison with those with normal aortic compliance.
Conclusions 1. Pulse pressure, LVMI and renal parameters do not differ significantly in young patients with white-coat hypertension and impaired aortic compliance in comparison with those with normal aortic compliance. 2. Aortic compliance is impaired in young patients with white-coat hypertension similarly to the patients with "true" hypertension while 24-h blood pressure profile and LV mass is normal. It suggests that increased PWV in patients with white-coat hypertension is of functional origin and caused by measurement procedure similarly to the "white-coat" effect.

Abstract

Background It is suggested that patients with white-coat hypertension have increased risk of cardiovascular complications. Impaired aortic compliance and increased left ventricular mass are independent cardiovascular risk factors in hyperttensive patients. Evaluation of these parameters in patients with white-coat hypertension may answer the question if these patients are of high cardiovascular risk and should be treated with antihypertensive drugs. The aim of the study was to compare aortic compliance, blood pressure profile, left ventricular mass index and renal hemodynamic parameters in young patients with "true" hypertension, white-coat hypertension and normal blood pressure.
Material and methods Eighty patients with initial diagnosis of arterial hypertension and 30 normotensives (group N), aged 19–40 years, were studied.
The following procedures were performed: clinic blood pressure with sphygmomanometer and 24-hour automatic blood pressure monitoring (ABPM), the estimation of aortic PWV, left ventricular mass index (LVMI) and renal hemodynamic parameters. Based on ABPM patients were divided as having "true" hypertension (group H) and white-coat hypertension (group NBF). The patients were also divided on subgroups according to PWV: HC+ (PWV < 9.2 m/s) i HC– (PWV > 9.2 m/s).
Results Mean pulse pressure was 51.6 ± 7.4 mm Hg in group H and was significantly higher (p < 0,001) than in group N (41.9 ± 5.7 mm Hg) and NBF (42.2 ± 10.2 mm Hg).
Mean PWV was lower in group N (8.24 ± 1.0 m/s) in comparison with group H (10.38 ± 2.5 m/s) i group NBF (10.48 ± 2.1 m/s) (p < 0.001). PWV did not differ between group H and NBF. Mean LVMI was 114.1 ± 10.4 g/m2 in group H, 94.0 ± 9.6 g/m2 in group N and 98.5 ± 7.7 g/m2 in group NBF. LVMI was significantly higher and renal plasma flow was significantly lower in "true" hypertensives in comparison with normotensives and patients with white coat hypertension. Strong correlations were found between pulse pressure and PWV and LVMI. No difference was found in pulse pressure, LVMI and renal parameters between patients with white-coat hypertension and impaired aortic compliance in comparison with those with normal aortic compliance.
Conclusions 1. Pulse pressure, LVMI and renal parameters do not differ significantly in young patients with white-coat hypertension and impaired aortic compliance in comparison with those with normal aortic compliance. 2. Aortic compliance is impaired in young patients with white-coat hypertension similarly to the patients with "true" hypertension while 24-h blood pressure profile and LV mass is normal. It suggests that increased PWV in patients with white-coat hypertension is of functional origin and caused by measurement procedure similarly to the "white-coat" effect.
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Keywords

aortic compliance; white-coat hypertension; target organ damage

About this article
Title

Aortic compliance, blood pressure pattern and target organ damage in young patients with white-coat hypertension

Journal

Arterial Hypertension

Issue

Vol 9, No 1 (2005)

Pages

45-54

Published online

2005-02-04

Bibliographic record

Nadciśnienie tętnicze 2005;9(1):45-54.

Keywords

aortic compliance
white-coat hypertension
target organ damage

Authors

Beata Krasińska
Andrzej Tykarski
Olga Trojnarska

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