title: Subclinical Organ Damage in White-Coat Hypertension: The Possible Role of Cystatin C.
abstract: The authors investigated the relationship of white-coat hypertension (WCH) with subclinical organ damage and potential relevant mechanisms. A total of 386 untreated patients were enrolled and divided into 204 patients with WCH and 183 with normotension. Flow-mediated dilation (FMD), pulse wave velocity (PWV), intima-media thickness, left ventricular mass index (LVMI), and cystatin C levels were measured. All tests were two-sided, and a P value <.05 was considered statistically significant. The WCH group exhibited higher LVMI and PWV values, decreased E/A ratio and FMD values, and increased prevalence for left ventricular hypertrophy compared with controls (P<.001 for all). Cystatin C was significantly higher in the WCH group compared with controls (P=.035) and was positively associated with LVMI (P<.05 for both). The presence of WCH is associated with more pronounced subclinical organ damage compared with normotension. Cystatin C may play a significant role and therefore warrants further investigation.
authors.affiliation: Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Androulakis
authors.affiliation: Barts Heart Centre, St Bartholomew's Hospital, London, UK.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papageorgiou
authors.affiliation: Renal Unit, King's College Hospital London NHS Foundation Trust, London, UK.
authors.forename: Eirini
authors.initials: E
authors.lastname: Lioudaki
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Chatzistamatiou
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Effimia
authors.initials: E
authors.lastname: Zacharia
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kallikazaros
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D059168:Carotid Intima-Media Thickness; D055316:Cystatin C / Q000378:metabolism*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059466:White Coat Hypertension / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology
chemical_list: D055316:Cystatin C