[White-coat arterial hypertension and stable borderline essential arterial hypertension. An ultrasonic study of the carotid arteries].
BACKGROUND
This study was designed to explore atherosclerotic lesions of the extracranial carotid arteries in patients with white-coat hypertension.


METHODS
Using high resolution B-mode echography of the extracranial carotid arteries we examined 45 patients with white-coat hypertension compared with 60 normotensive subjects and 95 patients with essential arterial stable borderline hypertension. We considered abnormally high any intimal-medial thickness of > or = 0.95 mm, calculated as the mean of 5 measurements from the common carotid artery at 2-3 cm from the flow divider; and we called plaque any focal thickening of > or = 2 mm classified echographically as hard, fibrous, mixed, soft, or haemorrhagic, or in terms of lesion sites, e.g., common carotid, carotid bifurcation, or internal and external carotid.


RESULTS
In patients with white-coat hypertension, compared to normotensive controls, we found the same prevalence of normal carotid vessels with intimal-medial thickening and one or more plaques; whereas compared to patients with essential arterial stable borderline hypertension we found a significantly lower prevalence of carotid vessels with intimal-medial thickening (p = 0.005) and one or more plaques (p = 0.02), plus a significantly higher prevalence of normal carotids (p = 0.001). The most frequent site of plaque formation was the common carotid and bifurcation; less so the internal and external carotid arteries. The most common type was the hard plaque; less common were fibrous, mixed and soft plaques.


CONCLUSIONS
In conclusion, unlike stable hypertension, white-coat hypertension in patients with clinical stable borderline hypertension is apparently associated with low risk of vascular lesions, practically to the same level as normotensive subjects.
Prencipe
G
G
Servizio di Cardiologia, Ospedale Civile San Camillo de Lellis, Manfredonia, Foggia.
Pellegrino
L
L
D000368:Aged; D000704:Analysis of Variance; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data
Ipertensione arteriosa da camice bianco ed ipertensione arteriosa essenziale borderline stabile. Studio ultrasonografico delle arterie carotidi.