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(Hypertension. 1995;26:413-419.)
© 1995 American Heart Association, Inc.
Articles |
Is White Coat Hypertension Associated With Arterial Disease or Left Ventricular Hypertrophy?
From the Department of Medicine, The New York Hospital–Cornell Medical Center, New York (M.J.R., T.G.P., R.B.D.); the Institute of Gerontology and Geriatrics, University of Firenze (Italy) (M.C.C., R.P.); and the Department of Psychiatry and Behavioral Science, State University of New York–Stony Brook (J.E.S.).
Correspondence to Mary J. Roman, MD, Division of Cardiology, Box 222, The New York Hospital–Cornell Medical Center, 525 E 68th St, New York, NY 10021.
Abstract Although white coat hypertension may be present in 20% or more of hypertensive individuals, its prognostic significance is unknown. We compared prognostically relevant measures of target-organ damage among 24 individuals with white coat hypertension and age- and sex-matched groups of sustained hypertensive and normotensive subjects classified by clinical and 24-hour ambulatory blood pressures. Left ventricular and carotid artery structure and function were evaluated by ultrasonography. Left ventricular mass index was similar in white coat hypertensive (82±17 g/m2) and normotensive (78±15 g/m2) subjects but was higher in sustained hypertensive subjects (97±19 g/m2, P<.02 and P<.002, respectively). Similarly, carotid artery intimal-medial thickness was greater in the sustained hypertensive group (0.98±0.21 mm) than in the white coat hypertensive (0.84±0.16 mm, P<.05) and normotensive (0.76±0.18 mm, P<.001) groups. The prevalence of discrete atherosclerotic plaques was higher in the sustained hypertensive group (58%) than in the white coat hypertensive (25%, P<.05) and normotensive (21%, P<.02) groups. Cardiac and carotid structure in individuals with white coat hypertension resemble findings in normotensive subjects and differ significantly from those in age- and sex-matched sustained hypertensive subjects. These findings suggest that white coat hypertension may be a benign condition for which pharmacological intervention may not be necessary, a hypothesis that needs to be tested in longitudinal studies with clinical end points.
Key Words: hypertension, white coat • hypertrophy, left ventricular • atherosclerosis • carotid arteries
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