Target Organ Damage in “White Coat Hypertension” and “Masked Hypertension” (original) (raw)

Journal Article

,

1

Department of Medicine, Aristotle University

,

Thessaloniki

,

Greece

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,

2

Department of Clinical Therapeutics, National and Kapodestrial University

,

Athens

,

Greece

3

Department of Paediatrics, National and Kapodestrial University

,

Athens

,

Greece

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2

Department of Clinical Therapeutics, National and Kapodestrial University

,

Athens

,

Greece

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,

2

Department of Clinical Therapeutics, National and Kapodestrial University

,

Athens

,

Greece

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,

2

Department of Clinical Therapeutics, National and Kapodestrial University

,

Athens

,

Greece

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,

1

Department of Medicine, Aristotle University

,

Thessaloniki

,

Greece

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,

1

Department of Medicine, Aristotle University

,

Thessaloniki

,

Greece

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,

4

University of Toronto

, Toronto,

Ontario

,

Canada

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,

1

Department of Medicine, Aristotle University

,

Thessaloniki

,

Greece

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2

Department of Clinical Therapeutics, National and Kapodestrial University

,

Athens

,

Greece

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Revision requested:

20 September 2007

Accepted:

16 January 2008

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Vasilios Kotsis, Stella Stabouli, Savvas Toumanidis, Christos Papamichael, John Lekakis, George Germanidis, Apostolos Hatzitolios, Zoe Rizos, Michael Sion, Nikos Zakopoulos, Target Organ Damage in “White Coat Hypertension” and “Masked Hypertension”, American Journal of Hypertension, Volume 21, Issue 4, April 2008, Pages 393–399, https://doi.org/10.1038/ajh.2008.15
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Abstract

Background

In this study we investigated (i) the prevalence of white coat hypertension (WCH) and masked hypertension (MH) in patients who had never been treated earlier with antihypertensive medication, and (ii) the association of these conditions with target organ damage.

Methods

A total of 1,535 consecutive patients underwent office blood pressure (BP) measurements, 24-h ambulatory BP monitoring (ABPM), echocardiography, and ultrasonography of the carotid arteries. Subjects who showed normotension or hypertension on the basis of both office and ambulatory BP (ABP) measurement were characterized as having confirmed normotension or confirmed hypertension, respectively. WCH was defined as office hypertension with ambulatory normotension, and MH as office normotension with ambulatory hypertension.

Results

WCH was found in 17.9% and MH in 14.5% of the subjects. The prevalence of WCH was significantly higher in subjects with obesity, while the prevalence of MH was significantly higher in normal-weight subjects. The confirmed hypertensive subjects as well as the masked hypertensive subjects had significantly higher left ventricular mass (LVM) (corrected for body surface area) and carotid intima media thickness (cIMT) than the confirmed normotensive subjects did (108.9 ± 30.6, 107.1 ± 29.1 vs. 101.4 ± 29.9 g/m2 and 0.68 ± 0.16, 0.68 ± 0.21 vs. 0.63 ± 0.15 mm, respectively, P < 0.005). White coat hypertensive subjects did not have a significantly higher LVM index than confirmed normotensive subjects (101.5 ± 25.9 vs. 101.4 ± 29.9 g/m2); they tended to have higher cIMT than the confirmed normotensive subjects, but the difference was not statistically significant (0.67 ± 0.15 vs. 0.63 ± 0.15 mm).

Conclusions

WCH and MH are common conditions in patients who visit hypertension outpatient clinics. Confirmed hypertension and MH are accompanied by increased LVM index and cIMT, even after adjusting for other risk factors.

© American Journal of Hypertension, Ltd. 2008

Topic:

• antihypertensive agents
• obesity
• hypertension
• hypertension, labile
• echocardiography
• ultrasonography
• carotid arteries
• left ventricle
• blood pressure
• ambulatory care facilities
• ambulatory blood pressure monitoring
• body surface area
• end organ damage
• hypertension, masked
• megalencephalic leukoencephalopathy with subcortical cysts
• carotid intima-media thickness

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