title: Central pressures and central hemodynamic values in white coat hypertensives are closer to those of normotensives than to those of controlled hypertensives for similar age, gender, and 24-h and nocturnal blood pressures.
abstract: BACKGROUND
  There is disagreement whether white coat hypertensives (WCH) have different hemodynamic and structural characteristics compared to normotensives (NT) and hypertensives (HT).
  
  
  METHODS
  We compared cardiovascular prognostic markers (pulse wave velocity [PWV] and aortic stiffness index [ASI]) and data on central hemodynamics and central pressures (augmentation index [AIx], augmentation pressure [AugP] and pulse pressure amplification [PPA]) from aortic pulse wave analysis between NT (n=175), WCH (n=315) and treated HT (n=691), all with 24-h blood pressure (BP) <130/80 and nocturnal BP <120/70 mmHg after matching for age, gender, body mass index (BMI) and and nocturnal BP. The groups were also compared separately in terms of 24-h systolic BP <120 mmHg and 120-129 mmHg.
  
  
  RESULTS
  The percentage of non-dippers was 40.1% in NT, 34.5% in WCH and 38.3 in HT. For similar 24-h and nocturnal systolic BP (NT 109/64±7/5, WCH 110/66±7/6, HT 109/64±7/5 mmHg), aortic stiffness was greater in HT (n=691, PWV 10.8±2.6 m/s and ASI 0.33±0.16, p<0.01) than in WCH (n=316, PWV 9.7±2.4 m/s and ASI 0.28±0.17) and NT (n=175, PWV 9.5±2.0 m/s and ASI 0.29±0.15); AugP and AIx were higher (p<0.01) in HT (13.9±8.2 and 29.6±12.6 mmHg) than in WCH (11.5±8.5 mmHg and 24.9±15.2) and NT (11.0±6.4 mmHg and 26.6±11.5). PPA was lower (p<0.01) in HT (11.3±5.5 mmHg) than in WCH (13.2±7.1 mmHg) and in NT (12.4±4.9 mmHg). The findings were similar when the 24-h systolic BP <120 mmHg and 120-129 mmHg subgroups were analyzed separately.
  
  
  CONCLUSIONS
  Our data suggest that for similar age, gender distribution, BMI, and 24-h and nocturnal BP, aortic stiffness, central aortic pressures and wave reflection in WCH are closer to those of NT than to those with treated HT. This supports the idea that white coat hypertension may be a more benign condition than treated hypertension for similar 24-h and particularly nocturnal BP levels.
authors.affiliation: Departamento de Medicina e Cintesis, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Almeida
authors.affiliation: Departamento de Medicina e Cintesis, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Monteiro
authors.affiliation: Unidade de Hipertensão e RCV, Hospital Pedro Hispano, ULS Matosinhos, Matosinhos, Portugal.
authors.forename: José A
authors.initials: JA
authors.lastname: Silva
authors.affiliation: Departamento de Medicina e Cintesis, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Bertoquini
authors.affiliation: Departamento de Medicina e Cintesis, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Unidade de Hipertensão e RCV, Hospital Pedro Hispano, ULS Matosinhos, Matosinhos, Portugal. Electronic address: jjpolonia@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Polónia
mesh_terms: D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012737:Sex Factors; D059289:Vascular Stiffness / Q000502:physiology; D059466:White Coat Hypertension / Q000503:physiopathology*
keywords: Aortic stiffness; Central aortic pressures; Hipertensão da bata branca; Nocturnal blood pressure; Ondas refletidas; Pressão arterial noturna; Pressão central; Rigidez aórtica; Wave reflection; White coat hypertension