Document Detail


Clinical implications of white coat hypertension.
MedLine Citation:
PMID:  8879598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the clinical implications of mild white coat hypertension (WCH). SUBJECTS AND METHODS: We studied 102 subjects (54 men, 48 women), 51 of whom were normotensive and 51 slightly hypertensive. None had ever received antihypertensive therapy. An ambulatory blood pressure (ABP) record (Accutracker II), a 24-h electrocardiogram and an echocardiogram were obtained from each, and each was examined by funduscopy. WCH subjects were compared with sustained hypertension (SH) subjects and with normotensives. RESULTS: Fifty-three percent of the hypertensives qualified as WCH. The ultrasonographic characteristics and the ABP variables of the WCH group differed significantly from those of normotensives, but not from those of the SH group. The prevalence of left ventricilar hypertrophy (LVH) in the SH group (62.5%) did not differ significantly from its prevalence in the WCH group (40.7%), but the prevalence among normotensives (17.6%) was significantly lower than in either of the other two groups. The WCH and SH groups did not differ significantly as regards the prevalence of hypertensive retinopathy (33.3% in the former, 58.3% in the latter). For no non-LVH, non-retinopathic subject, whether normotensive or hypertensive, were more than 18% of daytime diastolic ABP measurements > or = 90 mmHg. Ultrasonographic findings were no better correlated with ABP than with in-clinic BP measurements. Fundus findings correlated well with in-clinic BP and with numerous ABP parameters. Retinopathy, with or without LVH, was efficiently predictable among hypertensives on the basis of body mass index and the 24-h maximum of systolic BP. CONCLUSIONS: Myocardiac remodelling and vascular retinopathy develop early and in parallel in hypertensives, and both developments appear to involve determinants including body mass index and 24-h maximum systolic BP. WCH subjects, as defined by current ABP-based criteria, have cardiac and retinovascular characteristics different to normotensive subjects. Stricter criteria are needed to discriminate between hypertensives with and without the systemic developments that constitute the immediate source of risk to the hypertensives individual.
Authors:
A Pose-Reino; J R González-Juanatey; C Pastor; I Méndez; J C Estévez; D Alvarez; L Valdés; J Cabezas-Cerrato
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Blood pressure     Volume:  5     ISSN:  0803-7051     ISO Abbreviation:  Blood Press.     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1997-01-17     Completed Date:  1997-01-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  264-73     Citation Subset:  IM    
Affiliation:
Service of Internal Medicine, Complejo Hospitalario de Santiago, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / complications,  physiopathology
Blood Pressure / physiology
Body Constitution
Electrocardiography, Ambulatory
Eye / blood supply
Female
Humans
Hypertension / complications,  etiology,  physiopathology*
Hypertrophy, Left Ventricular / complications,  physiopathology
Male
Middle Aged
Reference Values
Vectorcardiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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