Objectives: The risk profile of white-coat hypertension/effect (WCH/E) remains unclear. This study aimed to investigate the relationship between WCH/E, markers of cardiovascular risk and cerebrovascular events.
Methods: This is a sub-group analysis of The Arterial Stiffness In lacunar Stroke and Transient ischemic attack (ASIST) study, which recruited 96 patients aged at least 40 years old with a diagnosis of transient ischemic attack or lacunar stroke in the preceding 14 days. Thirty-two patients with target blood pressure (clinic blood pressure <140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) and 30 patients with WCH/E (clinic blood pressure ≥140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) were included in the analysis.
Results: Patients with WCH/E were older and had a higher BMI. Central SBP (145 ± 13 vs. 118 ± 8 mmHg, P < 0.001) and DBP (82 ± 8 vs. 76 ± 7 mmHg, P = 0.004) were higher in those with WCH/E. They also had higher arterial stiffness measured by carotid-femoral pulse wave velocity (11.9 ± 3.0 vs. 9.6 ± 2.3 m/s, P = 0.002) and cardio-ankle vascular index (10.3 ± 1.3 vs. 9.4 ± 1.7, P = 0.027). Regression analysis showed an independent relationship between WCH/E and both measures of arterial stiffness. Lacunar strokes were more prevalent in those with WCH/E (47 vs. 22%, P = 0.039) and individuals in this group were more likely to have had a lacunar stroke than a transient ischemic attack (odds ratio 9.6, 95% CI 1.5-62.6, P = 0.02).
Conclusion: In this cohort of patients with lacunar stroke and transient ischemic attack, WCH/E was associated with elevated markers of cardiovascular risk and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.
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http://dx.doi.org/10.1097/HJH.0000000000003073 | DOI Listing |
Egypt Heart J
December 2024
Department of Internal Medicine, HIND Institute of Medical Sciences, Barabanki, India.
Background: Hypertension is a leading cause of premature mortality and morbidity. Recent guidelines advocate for out-of-office blood pressure monitoring, including ambulatory and home BP monitoring, to better identify hypertension phenotypes like masked hypertension, white coat hypertension, and sustained hypertension. However, clinical inertia persists due to a lack of robust evidence on the effectiveness of screening these phenotypes and their association with cardiovascular and all-cause mortality.
View Article and Find Full Text PDFCurr Med Res Opin
December 2024
Atherosclerosis and Vascular Biology Laboratory (Aterolab), Division of Cardiology, State University of Campinas (Unicamp), Sao Paulo, Brazil.
Background: White coat effect (WCE) is a phenomenon linked to increased cardiovascular risk, where office blood pressure readings exceed home or ambulatory measurements. Excess weight and elevated blood pressure or glucose are associated with WCE in type 2 diabetes (T2D). This study compared dapagliflozin and glibenclamide on WCE in T2D patients under equivalent blood pressure and glucose control.
View Article and Find Full Text PDFItal J Pediatr
October 2024
Division of pediatric nephrology, Department of Pediatrics, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Hypertension
November 2024
University College London (UCL) Institute of Cardiovascular Science and National Institute for Health Research, UCL Hospitals Biomedical Research Centre, United Kingdom (B.W.).
Background: Resistant hypertension is characterized by elevated blood pressure (BP) despite using 3 antihypertensive agents. Ambulatory BP monitoring (ABPM) detects the presence of white-coat resistant hypertension (24-hour BP <130/80 mm Hg). The aim of the study was to evaluate risks of death in resistant hypertension compared with controlled hypertension, as well as in ABPM-confirmed (24-hour BP ≥130 or 80 mm Hg), versus white-coat resistant hypertension.
View Article and Find Full Text PDFJ Hypertens
November 2024
South-Buda Center Hospital St. Imre University Teaching Hospital, Department of Cardiology.
Objective: Blood pressure (BP) lowering therapy in hypertension can markedly reduce the risk of cardiovascular diseases. In case of high-normal office blood pressure (oBP), the initiation of antihypertensive medication is recommended by guidelines in patients with very high cardiovascular risk. The aims of this study were to evaluate the presence of white-coat high-normal BP (WhHNBP) and masked hypertension in high-normal oBP and to explore the prevalence of untreated very high cardiovascular risk patients.
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