This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chang, N.-C. Articles by Wang, T.-C. Search for Related Content PubMed PubMed Citation Articles by Chang, N.-C. Articles by Wang, T.-C.

(Hypertension. 1997;30:746.)
© 1997 American Heart Association, Inc.

Articles

Left Ventricular Filling Profiles in Young White-Coat Hypertensive Patients Without Hypertrophy

Nen-Chung Chang; Zhi-Yang Lai; Paul Chan; Tze-Che Wang

From the Section of Cardiology, Department of Medicine, Taipei Medical College and Hospital (N.-C.C., Z.-Y.L., T.-C.W.), and the Section of Cardiology, Wang Fang Hospital, Taipei Medical College (P.C.), Taipei, Taiwan.

Correspondence to Nen-Chung Chang, MD, PhD, Section of Cardiology, Department of Medicine, Taipei Medical College Hospital, 2F, 29, Ln 13, Sec 2, Chin-San South Rd, Taipei 10603, Taiwan.

Abstract This study was to assess left ventricular diastolic function in young white-coat hypertensive subjects <50 years of age without hypertrophy. Hypertensive patients (systolic or diastolic blood pressure 140 or 90 mm Hg on all three visits) were defined as white coat if their average 24-hour blood pressure was <127/81 mm Hg and at least 18/16 mm Hg lower than their average office values. We chose three groups balanced for sex, age, and body mass index: 50 sustained hypertensives, 25 white-coat hypertensives, and 25 normotensives. Office blood pressure was similar in white-coat and sustained hypertensives. Ambulatory blood pressure was comparable in white-coat hypertensives and normotensives. Compared with normotensives, white-coat hypertensives had more impaired diastolic function: increased ratio of late to early filling velocities, raised ratio of late to early time-velocity integral, prolonged deceleration time, and lengthened isovolumic relaxation time (P<.001, P<.001, P=.002, and P<.001, respectively). No difference was noticed between white-coat and sustained hypertensives. Compared with normotensives, white-coat hypertensives had higher values of plasma and urine norepinephrine (P<.001 and P<.001, respectively), plasma and urine aldosterone (P<.001 and P=.002, respectively), plasma renin activity (P=.04), total cholesterol (P=.001), and LDL cholesterol (P<.001). No difference was observed between white-coat and sustained hypertensives. Within white-coat hypertensives, 24-hour urinary aldosterone closely correlated with the ratio of late to early filling velocities (P=.008), and plasma and 24-hour urinary norepinephrine correlated well with total cholesterol (P=.037 and P=.006, respectively). No correlation was detected within the sustained hypertensives and normotensives. Heightened neurohumoral activity clearly supported the progression of diastolic dysfunction and metabolic abnormality in white-coat hypertensives.

Key Words: hypertension, white coat • ventricular function • echocardiography • blood pressure monitoring • angiotensin system

This article has been cited by other articles:

				A. M. Grandi, R. Broggi, S. Colombo, R. Santillo, D. Imperiale, A. Bertolini, L. Guasti, and A. Venco Left Ventricular Changes in Isolated Office Hypertension: A Blood Pressure-Matched Comparison With Normotension and Sustained Hypertension Arch Intern Med, December 10, 2001; 161(22): 2677 - 2681. [Abstract] [Full Text] [PDF]