White-coat hypertension and cardiovascular risk.
OBJECTIVE
To compare cardiovascular risk in white-coat hypertensives, normotensives and established hypertensives.


METHODS
We studied 61 hypertensive individuals, 27 of whom were white-coat hypertensives, and 35 normotensives. All subjects underwent 24 h noninvasive blood pressure monitoring and Doppler echocardiographic examination of the heart; urine was tested for microalbuminuria and the fundi of the eyes examined for retinopathy.


RESULTS
The 24 h as well as the day- and night-time mean systolic blood pressure (SBP) was slightly but significantly higher in white-coat hypertensives than in normotensives; no significant difference was observed in diastolic blood pressure (DBP) between these groups. In white-coat hypertensives, 24 h SBP and DBP were lower than in established hypertensives (P < 0.001). The echocardiographic study showed higher values of posterior wall thickness, left ventricular mass index (LVMI), and ventricular septum thickness (P < 0.05) in white-coat hypertensives than in normotensives; fractional shortening and ejection fraction were similar. The E:A ratio, obtained from the Doppler study, was lower in white-coat hypertensives than in normotensives (1.14 +/- 0.3 versus 1.24 +/- 0.25; P < 0.05). LVMI values were smaller in white-coat hypertensives than in established hypertensives (P < 0.05), and both ejection fraction and fractional shortening were similar in the two groups. Among white-coat hypertensives, eight out of 27 showed hypertensive retinal damage; microalbuminuria values were similar to those obtained in normotensives.


CONCLUSIONS
The results of this cross-sectional and therefore limited study lead us to hypothesize that white-coat hypertensives are at higher risk than normotensives and lower risk than established hypertensives for developing cardiovascular damage.
Cerasola
G
G
Internal Medicine and Hypertension Center, University of Palermo, Italy.
Cottone
S
S
Nardi
E
E
D'Ignoto
G
G
Volpe
V
V
Mulé
G
G
Carollo
C
C
D000328:Adult; D000419:Albuminuria / Q000209:etiology; D003327:Coronary Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012307:Risk Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D016277:Ventricular Function, Left