Effect of white-coat hypertension on arterial stiffness

Cai, Ping; Peng, Yan; Wang, Yan; Wang, Xukai

doi:10.1097/md.0000000000012888

Cited by 21 publications

(22 citation statements)

References 26 publications

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“…There is another meta‐analysis, conducted by Cai et al, in which authors pooled the results for both treated and untreated patients in their effort to investigate the WCH population in relation to c‐f PWV. This effort raises queries about possible selection bias 9 . However, according to the latest guidelines of the ESC/ESH, these two phenotypes are mainly referred to patients not being treated with antihypertensive agents and now seem to be even more separated from the treated population as two terms now are introduced (the masked uncontrolled and the white‐coat uncontrolled hypertension accordingly for the treated population) 3 …”

Section: Discussionmentioning

confidence: 99%

“…Study estimates were pooled using an inverse variance weighting. The DerSimonian‐Laird estimate was used to calculate the between‐study variance 9 . A prediction interval for the phenotype effect of a new study was also calculated as proposed by Higgins 13 .…”

Section: Methodsmentioning

confidence: 99%

“…To our knowledge, this is the first meta‐analysis showing the effect of MΗ and WCH on arterial stiffness in the untreated population. There is only one other meta‐analysis investigating the relation of WCH on c‐f PWV but in both treated and untreated patients, 9 whereas there is no similar published meta‐analysis for the MH population.…”

Section: Introductionmentioning

confidence: 99%

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Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis

Antza

Vazakidis

Doundoulakis

et al. 2020

J of Clinical Hypertension

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Registration number (DOI): Available in https://osf.io/974gb/, https://doi.Abstract Arterial damage of large arteries, addressed as c-f PWV, is recognized as independent predictor for future cardiovascular disease. The aim of this study was to systematically investigate the association of the four hypertension phenotypes with carotidfemoral pulse wave velocity (c-f PWV), in untreated patients. PubMed and Cochrane Library were searched to identify studies comparing c-f PWV levels between normotensives, sustained hypertensives, white-coat hypertensives (WCH), and masked hypertensives (MH). Meta-analysis was performed to compare the difference c-f PWV levels between these groups. Newcastle-Ottawa quality assessment scale for crosssectional studies was used to assess study quality. MH and WCH patients had significantly increased c-f PWV values compared to the normotensive groups (d = 0.96 m/s, 95% CI: 0.49-1.42; I2 = 85%, P < .01 for MH and d = 0.85 m/s, 95% CI: 0.48-1.22; I2 = 89%, for WCH). Moreover, the sustained hypertensive population was found to have significantly increased values of c-f PWV compared to MH (d = −0.70 m/s, 95% CI: −0.87 to −0.54; I2 = 12%, P = .33) but not compared to WCH population (d = −0.75 m/s, 95% CI: −1.52-0.02; I 2 = 96%,). Finally, there was no significant difference between MH and WCH population (d = 0.06 m/s, 95% CI: −1.04 to 1.15; I 2 = 96%,). MH and WCH population may have increased values of c-f PWV compared to the normotensive group. These results demonstrate that these phenotypes are not clinically innocent, in the untreated population.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis

Antza

Vazakidis

Doundoulakis

et al. 2020

J of Clinical Hypertension

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“…WCHT appears to cause cardiovascular damage [7]. However, most previous studies used the traditional diagnostic criteria, that is, only relying on daytime ambulatory BP monitoring or 24-h ambulatory average BP to define hypertension phenotypes such as WCHT, without considering the impact of nocturnal hypertension on the hypertension phenotypes classification [8][9][10]. The 2014 European Society of Hypertension practice guidelines proposed a classification method combining daytime BP, nighttime BP, 24-h BP, and clinic BP to classify hypertension phenotypes, which is accepted worldwide [11].…”

Section: Introductionmentioning

confidence: 99%

Effects of white-coat, masked and sustained hypertension on coronary artery stenosis and cardiac arrhythmia

Cai

Wang

et al. 2019

Hypertens Res

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This study aimed to investigate whether hypertension phenotypes such as white-coat hypertension (WCHT), diagnosed with the addition of nighttime blood pressure (BP) criteria, are related to coronary artery stenosis (CAS) and cardiac arrhythmia. In this cross-sectional observational study, 844 participants who did not use antihypertensive, lipid-lowering, and antiplatelet drugs were selected. The subjects were divided into normotensive (NT), WCHT, masked hypertension (MHT), and sustained hypertension (SHT) groups based on the results of clinic BP measurement and ambulatory BP monitoring. Coronary angiography and ambulatory electrocardiography were performed to determine the participants' CAS and cardiac arrhythmia status. Coronary angiography revealed 556 patients with CAS and 288 participants with normal coronary arteries. The chisquared test showed that the incidence of CAS was higher in the MHT and SHT groups than in the NT group, while no significant change was found in the WCHT group (P = 0.003, P < 0.001, P = 0.119). The logarithm of the Gensini score was used to compare the degree of CAS between the groups. Multiple linear regression analysis showed that the degree of CAS was higher in the WCHT, MHT, and SHT groups than in the NT group (P < 0.05). The incidences of frequent atrial premature beats, atrial tachycardia, and ventricular cardiac arrhythmia were significantly higher in the WCHT and SHT groups than in the NT group, while only ventricular cardiac arrhythmia changes were observed in the MHT group. This study found that hypertension phenotypes such as WCHT were closely associated with CAS and cardiac arrhythmia.NT normotension, WCHT white-coat hypertension, MHT masked hypertension, SHT sustained hypertension, Lg (Gensini score) the logarithm of Gensini score, SD standard deviation, β standardized regression coefficient, SE standard error *P value, WCHT versus NT; **P value, MHT versus NT; ***P value, SHT versus NT Effects of white-coat, masked and sustained hypertension on coronary artery stenosis and cardiac. . .

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“…However, whether WCH is only a benign clinical phenomenon or a criminal clinical disease is still controversial [4]. Especially since the European society of hypertension practice guidelines (2014 edition) revised the diagnostic criteria for WCH and excluded isolated nocturnal hypertension with de nite target organ injury effect from WCH, the de nite cardiovascular and cerebrovascular injury effect of WCH has not been found in many clinical studies [5,6]. For example, a large-scale clinical study including 115,708 samples in 2017 did not nd cardiovascular injury of WCH with normal ambulatory blood pressure in each time period [7].…”

Section: Introductionmentioning

confidence: 99%

How to Identify White Coat Hypertension at The First Diagnosis: Establishment of A Scoring Model for The Differential Diagnosis of White Coat Hypertension and Sustained Hypertension

Cai

Yan

Chen

et al. 2020

Preprint

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Background: To establish a scoring model for the differential diagnosis of white coat hypertension (WCH) and sustained hypertension (SHT). Methods: 553 adults with elevated office blood pressure, normal renal function and no antihypertensive drugs were included in this study. 17 parameters, such as gender and age, were obtained by questionnaire investigation and biochemical index detection. WCH and SHT were distinguished by 24-hour ambulatory blood pressure monitoring. Participants were randomly divided into a training set (445 cases) and a verification set (108 cases). In the training set, the above parameters were screened by LASSO regression and univariate logistic regression analysis, then, the scoring model was constructed through multivariate logistic regression analysis. ROC curve and calibration curve were used to discuss the discrimination and calibration of this scoring model respectivelyResults: 6 parameters were finally selected, namely isolated systolic hypertension, systolic blood pressure, diastolic blood pressure, triglyceride, serum creatinine, and cardiovascular and cerebrovascular diseases. Multivariate logistic regression was used to establish the scoring model. The R2 and AUC of the scoring model in the training set were 0.163 and 0.705, respectively. In the verification set, the R2 of the scoring model was 0.206, and AUC was 0.718. The calibration test results showed that the scoring model had good stability in both training set and verification set (MSE=0. 001, MAE=0. 014; MSE=0. 001, MAE=0. 025, respectively).Conclusion: A stable scoring model for distinguishing WCH can be established, which can assist clinical medical workers to identify WCH at the first diagnosis.

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Effect of white-coat hypertension on arterial stiffness

Cited by 21 publications

References 26 publications

Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis

Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis

Effects of white-coat, masked and sustained hypertension on coronary artery stenosis and cardiac arrhythmia

How to Identify White Coat Hypertension at The First Diagnosis: Establishment of A Scoring Model for The Differential Diagnosis of White Coat Hypertension and Sustained Hypertension

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