Abstract 4438: Office Blood Pressure is a Predictor of Arterial Elastic Properties in Patients with White Coat Hypertension
Background. White coat hypertension (WCH) has been related to target organ damage and increased cardiovascular risk. Arterial elastic properties are important determinants of cardiovascular performance and predictors of outcomes. We hypothesized that the blood pressure (BP) surge during the office visits is a better determinant of arterial function than the ambulatory BP in patients with WCH.
Methods. We studied 440 consecutive untreated non-diabetic patients (172 men, 268 women, age 52.5±12.3 years old) with WCH (office BP >140/90 mmHg, mean daytime ambulatory BP <135/85mmHg). Carotid-femoral pulse wave velocity (PWV), an index of aortic stiffness, and aortic augmentation index (corrected for heart rate), a composite marker of stiffness and wave reflections, were measured with validated non-invasive methods.
Results. Overall, the mean systolic BP (SBP)/diastolic BP was 158±9/98±7 mmHg and the mean daytime ambulatory BP was 124±8/77±5 mmHg. In univariate analysis, office SBP correlated significantly with both PWV (r=0.259, P<0.001, left plot) and AIx (r=0.30, P<0.001). In contrast, mean ambulatory SBP did not correlate with PWV (r=−0.021, P=0.66, right plot) or AIx. Multivariable analysis including age, gender, BMI, height and smoking status as covariates showed that only office SBP is an independent determinant of both PWV (P=0.036) and AIx (P=0.029).
Conclusion. In non-diabetic WCH individuals, office SBP is a predictor of arterial elastic properties. This finding suggests that the BP surge during the office visits may be a marker of cardiovascular risk in subjects with WCH.