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. 2022 Apr 1;40(4):758-764.
doi: 10.1097/HJH.0000000000003073.

White-coat hypertension/effect is associated with higher arterial stiffness and stroke events

Alec Saunders  1 , Gani N Nuredini  1 , Frances A Kirkham  2 , Erin Drazich  2 , Eva Bunting  2 , Philip Rankin  2 , Khalid Ali  1   2 , Michael Okorie  1 , Chakravarthi Rajkumar  1   2
Affiliations

White-coat hypertension/effect is associated with higher arterial stiffness and stroke events

Alec Saunders et al. J Hypertens. .

Abstract

Objectives: The risk profile of white-coat hypertension/effect (WCH/E) remains unclear. This study aimed to investigate the relationship between WCH/E, markers of cardiovascular risk and cerebrovascular events.

Methods: This is a sub-group analysis of The Arterial Stiffness In lacunar Stroke and Transient ischemic attack (ASIST) study, which recruited 96 patients aged at least 40 years old with a diagnosis of transient ischemic attack or lacunar stroke in the preceding 14 days. Thirty-two patients with target blood pressure (clinic blood pressure <140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) and 30 patients with WCH/E (clinic blood pressure ≥140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) were included in the analysis.

Results: Patients with WCH/E were older and had a higher BMI. Central SBP (145 ± 13 vs. 118 ± 8 mmHg, P < 0.001) and DBP (82 ± 8 vs. 76 ± 7 mmHg, P = 0.004) were higher in those with WCH/E. They also had higher arterial stiffness measured by carotid-femoral pulse wave velocity (11.9 ± 3.0 vs. 9.6 ± 2.3 m/s, P = 0.002) and cardio-ankle vascular index (10.3 ± 1.3 vs. 9.4 ± 1.7, P = 0.027). Regression analysis showed an independent relationship between WCH/E and both measures of arterial stiffness. Lacunar strokes were more prevalent in those with WCH/E (47 vs. 22%, P = 0.039) and individuals in this group were more likely to have had a lacunar stroke than a transient ischemic attack (odds ratio 9.6, 95% CI 1.5-62.6, P = 0.02).

Conclusion: In this cohort of patients with lacunar stroke and transient ischemic attack, WCH/E was associated with elevated markers of cardiovascular risk and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.

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References

    1. Fagard R, Cornelissen V. Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension: a meta-analysis. J Hypertens 2007; 25:2193–2198.
    1. Yavuzer S, Yavuzer H, Cengiz M, Erman H, Altiparmak M, Korkmazer B, et al. Endothelial damage in white coat hypertension: role of lectin-like oxidized low-density lipoprotein-1. J Hum Hypertens 2015; 29:92–98.
    1. Yavuzer H, Cengiz M, Yavuzer S, Altiparmak M, Korkmazer B, Balci H, et al. Procalcitonin and pentraxin-3: current biomarkers in inflammation in white coat hypertension. J Hum Hypertens 2016; 30:424–429.
    1. Sivén SSE, Niiranen TJ, Kantola IM, Jula AM. White-coat and masked hypertension as risk factors for progression to sustained hypertension. J Hypertens 2016; 34:54–60.
    1. Huang Y, Huang W, Mai W, Cai X, An D, Liu Z, et al. White-coat hypertension is a risk factor for cardiovascular diseases and total mortality. J Hypertens 2017; 35:677–688.

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