P-456: Increased cardiovascular risk in white coat hypertensives with office isolated systolic hypertension

Abstract

White coat hypertension (WCH) is accompanied by increased cardiac risk, while isolated systolic hypertension (ISH) is often burdened with target-organ damage. The effect of office ISH in patients with WCH has not been elucidated.

We studied 280 consecutive patients with WCH, defined as daytime BP<135/85 mmHg in 24-hour ambulatory BP monitoring. Office ISH (SBP>140 and DBP<90 mmHg) was documented in 95 patients (34 men and 61 women, 67.7±5.5 years old), who were compared to 185 gender- and age-matched patients (75 men and 110 women, 67.6±5.3 years old) with office systolodiastolic (>140/90 mmHg) hypertension.

In baseline drug-free echocardiographic examination, ISH patients had higher (p<0.0001) LV mass index values (136 vs 127 g/m²) and LV hypertrophy incidence (51.6 vs 22.2%), with both eccentric (27.4 vs 10.8% p=0.0004) and concentric geometry (24.2 vs 11.4% p=0.005). In 24-hour urine collection, ISH patients had higher (p<0.0001) microalbumin and α₁ microglobulin excretion (33 vs 20 and 8.3 vs 6.6 mg/L), with higher incidence of elevated urinary albumin/creatinine ratio (32.6 vs 8.6% p<0.0001).

It is concluded that in patients with WCH the presence of office ISH signifies increased cardiovascular risk with higher incidence and severity of target-organ damage.

Am J Hypertens (2004) 17, 200A–200A; doi: 10.1016/j.amjhyper.2004.03.530

White Coat Hypertension, Isolated Systolic Hypertension, Target Organ Damage