Topography and severity of coronary artery disease in white-coat hypertension.
BACKGROUND
White-coat hypertension (WCH) has been evaluated as a risk factor for cardiovascular disease. In this study, the role of WCH is evaluated in a cohort of patients with suspected coronary artery disease with both coronary angiography and non-invasive techniques.


METHODS
One hundred patients with suspected coronary artery disease underwent coronary angiography, 24-h ambulatory blood pressure monitoring (ABPM), and ultrasound imaging of the myocardium and carotids. The lesions in percentage of stenosis in the left coronary artery stem (LM), left anterior descending ramus (LAD), left circumflex artery (LCX), diagonal artery (D1), and right coronary artery (RCA), along with the Gensini score (GS), were recorded. After a series of manual blood pressure measurements, the patients were divided into two groups (patients with and patients without WCH).


RESULTS
GS was higher in the WCH group (P=0.042), a difference that could be attributed to lesions in the LAD (P=0.007). GS correlated significantly with left ventricular end-diastolic diameter (LVEDD - P=0.041), left ventricular end-systolic diameter (LVESD - P=0.005), end-diastolic volume (EDV - P=0.042), end-systolic volume (ESV - P=0.004), LvMass/BSA (P=0.012), right internal carotid artery intima-media thickness (RICA - P=0.018), left internal carotid artery intima-media thickness (LICA - P=0.021), and their mean (MICA - P=0.005) in the WCH group but not in normotensives.


CONCLUSIONS
Coronary disease may be more severe among patients with WCH than among those without. In this group, data from myocardial and carotid ultrasound may help to estimate coronary artery disease.
Kostandonis
Dimitrios
D
Department of Clinical Therapeutics, Division of Medicine, Athens University at Alexandra Hospital, GR 11527 Athens, Greece.
Papadopoulos
Vassilios
V
Toumanidis
Savvas
S
Papamichael
Christos
C
Kanakakis
Ioannis
I
Zakopoulos
Nikolaos
N
D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging