Isolated office hypertension and end-organ damage

Ferrara, L; Guida, L.; Pasanisi, Fabrizio; Celentano, Aldo; Palmieri, Vittorio; Iannuzzi, R.; Gaeta, Iole; Leccia, G.; Crivaro, Marina

doi:10.1097/00004872-199715090-00008

Cited by 28 publications

(15 citation statements)

References 37 publications

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“…Two blood pressure readings were recorded with patients in the sitting position for at least 5 min, between 0900 and 1100 h in the morning; the average of the two readings was considered as the measurement for that visit; twenty-four hour ambulatory blood pressure monitoring (ABPM), by Spacelabs Inc. 90207 (Redmond Washington, USA), during a normal working day, as already published. 11 The monitor was fitted on in the morning, between 1000 and 1200 hours Subjects were asked to perform their normal daily activities and to consume their habitual diet. After calibration, the monitor was programmed to record BP and heart rate (HR) at 15-min intervals during the subjects' waking hours and at 20-min intervals during their usual sleeping hours.…”

Section: Methodsmentioning

confidence: 99%

Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome

et al. 2007

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High blood pressure (BP) is one of the crucial determinants of the metabolic syndrome (MS). The extent to which MS, diagnosed according to the criteria of the International Federation of Diabetes, impacts on cardiovascular organ damage, independently of BP, is debated. Three hundred and forty hypertensive patients and 100 normotensive controls underwent the following procedures: (1) physical examination and resting BP measurements, (2) 24 h ambulatory BP monitoring, (3) laboratory routine examination, (4) echocardiography, (5) carotid ultrasonography and (6) ankle-brachial BP index. The syndrome was found in 104 of the 340 hypertensive patients (30.6). In comparison to those without MS, those with MS had significantly higher prevalence of left ventricular (LV) hypertrophy by mass/height 2.7 criteria (46 vs 42%, Po0.01) but not by LV mass/body surface criteria (30 vs 31%); the ratio between early-to-late peak velocities of the LV filling waves (E/A) was higher (E/ A ¼ 0.9970.14 vs 0.8970.15, Po0.01) and left atrium was larger (3.870.3 vs 3.570.5 cm, Po0.01). Both hypertensive groups had significantly greater LVM and carotid intima-media thickness than normotensives, without between-group-difference. In this hypertension outpatient clinic almost one-third hypertensive patients have MS. They show a deterioration in structure and function of the heart in comparison to hypertensive patients without MS, but no difference was detected in the carotid and peripheral arterial circulation.

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Section: Methodsmentioning

confidence: 99%

Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome

et al. 2007

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“…[15][16][17] On the other hand, different results have been obtained in other reports. [18][19][20][21][22][23][24][25][26] Various studies have suggested that only about one-half to two-thirds of the variation in the anatomic extent of atherosclerosis and risk for atherosclerotic vascular disease can be explained by classic risk factors. 27,28 Therefore, new risk factors have been investigated.…”

Section: Introductionmentioning

confidence: 99%

Circulating homocysteine levels in sustained and white coat hypertension

et al. 2003

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Although white coat hypertension has been widely studied in the last years, its risk profile is not yet completely clear. The aim of this study was to evaluate circulating homocysteine levels, an emerging cardiovascular risk factor, in subjects with white coat and sustained hypertension. We selected 31 sustained hypertensive subjects, 31 white coat hypertensive subjects and 31 normotensive subjects matched for age, gender, body mass index and occupation. Women were also matched for menopausal status. Subjects with smoking habit, dyslipidaemia and diabetes mellitus were excluded from the study. White coat hypertension was defined as clinical hypertension and daytime ambulatory blood pressure o135/85 mmHg. Blood samples were drawn after a fasting period of 12 h for routine laboratory tests and homocysteine determination. Homocysteine levels were evaluated by fluorescence polarization immunoassay. Creatinine, glucose, cholesterol and triglycerides were not different among the groups. White coat hypertensive subjects had significantly lower homocysteine levels than sustained hypertensive patients (8.2 7 2.0 vs 12.6 7 3.9 lmol/l, P ¼ 0.0003). No significant difference was observed between white coat hypertensive and normotensive subjects regarding this parameter (8.2 7 2.0 vs 7.6 7 1.9 lmol/l, P ¼ 0.9). In conclusion, our data show that middle-aged white coat hypertensive subjects without other cardiovascular risk factors have lower circulating homocysteine levels than sustained hypertensive patients suggesting that they are at lower cardiovascular risk.

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“…Many, but not all, of these studies have demonstrated increased LVMI in WCH subjects, with LVMI intermediate between that of subjects with normotension and those with sustained hypertension. [2][3][4][5][6][7][8][9][10][11][12][13] In addition, a recent study suggests that the long-term incidence of stroke may be elevated in adults with WCH. 14 Little is known about the clinical significance and natural history of WCH in children.…”

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confidence: 99%

Left Ventricular Mass Index in Children with White Coat Hypertension

Lande

Meagher

Fisher

et al. 2008

The Journal of Pediatrics

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Objective-To determine if children with white coat hypertension (WCH) have evidence of targetorgan damage by comparing left ventricular mass index (LVMI) of subjects with WCH to that of matched normotensive and hypertensive controls.Study design-Each WCH subject was matched by body mass index (± 10%), age (± 1 year), and sex to a normotensive control and to a hypertensive control. Echocardiograms were reviewed to determine LVMI for each subject. These triple matches were analyzed using repeated measures analysis of variance to detect differences in LVMI between the three groups.Results-Twenty-seven matched triplets were established. The groups were comparable for sex, age, and body mass index (BMI). Mean LVMI was 29.2, 32.3, and 35.1 g/m 2.7 , for normotensives, WCH, and sustained hypertensives, respectively (normotensive vs. WCH, p = 0.028; WCH vs. sustained hypertensive, p = 0.07). Left ventricular hypertrophy was not present in any subject in the normotensive or WCH groups, but was present in 26% of the sustained hypertensive subjects (p < 0.001).Conclusions-After controlling closely for BMI, children with WCH had a LVMI which was intermediate between that of normotensives and sustained hypertensives, suggesting that WCH may be associated with hypertensive end-organ effects.White coat hypertension (WCH) occurs when blood pressure is elevated in the medical office but is normal outside the office setting. In adults, there is concern that WCH may be an independent risk factor for cardiovascular disease or that it may represent a prehypertensive state, with increased risk of progression to sustained hypertension. 1 Numerous adult studies have evaluated left ventricular mass index (LVMI) in subjects with WCH. Many, but not all, Corresponding Author: Marc B. Lande, MD, 601 Elmwood Ave, Box 777, Rochester, NY 14642, Phone: 585-275-9784, Fax: 585-756-8054, Email: marc_lande@urmc.rochester.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The objective of the current study was to determine if children with WCH have evidence of hypertensive target-organ effects by comparing LVMI in children with WCH, normotension, and sustained hypertension, closely matching subjects for BMI, sex, and age. NIH Public Access MethodsThe study was performed at the University of Rochester Medical Center in Rochester, NY. At this center, ABPM has been used in the evaluation of pediatric primary hypertension since October 2002. The clinical purpose of ABPM has been primarily to differentiate between sustained hypertension and white coat hypertension. It has been our practice to obtain ech...

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Isolated office hypertension and end-organ damage

Abstract: These results, at variance with those of others, suggest that IOH affects the cardiovascular system even during the early phases of the disease and indicate the need for prospective clinical trials to evaluate the benefit from early treatment of IOH patients.

Cited by 28 publications

References 37 publications

Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome

Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome

Circulating homocysteine levels in sustained and white coat hypertension

Left Ventricular Mass Index in Children with White Coat Hypertension

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