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G. Mulè, E. Nardi, D. Ferrara, M. Federico, F. Raspanti, G. Piazza, V. Volpe, S. Cottone, G. Andronico, G. Cerasola, P-62: Relationships of “ambulatory” white coat effect with target organ damage in arterial hypertension, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Pages 49A–50A, https://doi.org/10.1016/S0895-7061(01)01540-0
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Abstract
Controversy remains on whether white coat effect (WCE) is a benign clinical phenomenon or carries an increased risk of target organ damage (TOD). Recently Owens et al (1) proposed to use the difference between the first measurement of ambulatory blood pressure (ABP) and the mean daytime pressure as a surrogate measure of WCE (“ambulatory” WCE).
In order to analyze the relationship between ambulatory white-coat effect and TOD, 130 essential hypertensives underwent noninvasive 24-h ABP monitoring, electrocardiogram, 2D-guided M-mode echocardiography, fundus oculi examination and microalbuminuria (AER) assay.
The study population was separated in two groups according to the median of the WCE, both for systolic and diastolic values. Because mean daytime pressure was lower in the subsets with higher WCE, the comparison between groups was made by ANCOVA adjusting for this variable.
While no difference was found between the subsets with high and low WCE with respect to AER and prevalence of hypertensive retinopathy, left ventricular mass index (LVMI) (125 ± 3.2 vs 116± 3.2 g/m2) and relative wall thickness (RWT) (0.40 ± 0.01 vs 0.37± 0.01) were greater (p < 0.05) in the group with high systolic WCE. The significant association between systolic WCE and LVMI was confirmed in the whole study population by the results of multiple regression analysis (β: 0.67; p=0.01), where sex, age, duration of hypertension, BMI, daytime systolic ABP were added to the model. No significant differences in AER, prevalence of hypertensive retinopathy and LVMI were found between the groups with high and low diastolic WCE.
Our results seem to suggest that ambulatory systolic white coat effect may not be an innocent phenomenon in terms of cardiac organ damage.
