Cardiac damage in hypertensive patients with inverse white coat hypertension. Hospitalet study.
BACKGROUND
Few studies have assessed the relationship between ambulatory blood pressure (BP) and cardiac damage in essential hypertensive patients with inverse white coat hypertension (IWCH).


OBJECTIVE
To determine the frequency of IWCH in untreated grade 1-2 hypertension and to assess possible differences in cardiac damage among patients with IWCH, white coat hypertension (WCH) and the rest of patients with grade 1-2 hypertension.


METHODS
Two hundred and eleven patients with grade 1-2 hypertension were sequentially included. A good quality 24-h ambulatory BP monitoring was obtained in 204 patients (age: 41 +/- 12 years, 56% males). IWCH was defined as a daytime systolic and/or diastolic BP higher than diagnostic office systolic and/or diastolic BP, respectively. WCH was defined as a daytime BP < 135/85 mmHg. A good quality echocardiogram was obtained in 174 patients. We considered left ventricular hypertrophy a left ventricular mass index (LVMI) > or = 125 g/m2.


RESULTS
We found IWCH in 29 subjects (14%), and WCH in 68 (33%). Office BP in patients with IWCH was in an intermediate position between WCH and the rest of grade 1-2 hypertension patients. The IWCH patients showed 24-h, daytime and night-time BP higher than the other groups. Left ventricular mass was significantly greater in patients with IWCH than in the other grade 1-2 hypertension patients after adjusting for age, gender, body mass index, smoking and office BP (regression coefficient 28.14, 95%CI: 7.36-48.91).


CONCLUSIONS
IWCH is independently associated with higher values of left ventricular mass in patients with grade 1-2 hypertension.
Hernández del-Rey
Raquel
R
Unit of Hypertension and Vascular Risk, Department of Internal Medicine, Consorci Sanitari de la Creu Roja a Catalunya, L'Hospitalet de Llobregat, Barcelona, Spain. Raquel.Hernandez@chcr.scs.es
Armario
Pedro
P
Martín-Baranera
Montserrat
M
Sánchez
Pilar
P
Almendros
Mari Cruz
MC
Coca
Antonio
A
Pardell
Helios
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000378:metabolism; D018660:Blood Pressure Monitoring, Ambulatory; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D016277:Ventricular Function, Left / Q000502:physiology