Left Ventricular Mass and Geometry in Patients With Established Hypertension and White Coat Hypertension

Høegholm, Asbjørn; Kristensen, Kjeld; Bang, Lia E.; Nielsen, J; Nielsen, Walter Bjørn; Madsen, N H

doi:10.1093/ajh/6.4.282

Cited by 79 publications

(32 citation statements)

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“…And importantly, we have earlier found ABP to be a better predictor of target-organ damage than OBP on cross-sectional data in this study population. 10,11 Longitudinal results have been published by others both in normotensive and in hypertensive populations and they show the same relations as our prospective results. [17][18][19] The high event rate in the WCH group raises the important question of whether there is also a positive relation between WCE and cardiovascular morbidity rate in our population.…”

Section: -Year Follow-up Of Wchsupporting

confidence: 91%

“…[10][11][12]16 In spite of our specific results on the WCH group, this study reveals quite expected overall relations between cardiovascular events and BP data. We found that the event rate was more strongly predicted from ABP than OBP.…”

Section: -Year Follow-up Of Wchcontrasting

confidence: 63%

“…Baseline evaluation included a detailed medical history, OBP and ABPM; these data have been reported previously. [9][10][11][12][13] All subjects gave their informed consent. The study was conducted in accordance with the second declaration of Helsinki and was approved by the local ethics committee.…”

Section: Study Populationmentioning

confidence: 99%

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White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study

Gustavsen¹,

Høegholm²,

Bang³

et al. 2003

J Hum Hypertens

172

117

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The objective of this paper was to evaluate the cardiovascular risk in white coat hypertension (WCH). WCH is a well-known clinical entity defined by persistently elevated blood pressure (BP) in the doctor's office, whereas BP in other conditions is normal. The prognosis of WCH is unsettled, although two prospective studies that include normal control groups imply that the condition is benign. This study is a 10-year follow-up study on 420 patients with grade I-II hypertension newly diagnosed by their general practitioner and 146 normal controls (NTs). Ambulatory blood pressure (ABP) monitoring was performed at baseline. With our protocollated cutoff value of daytime-ABP o135/ 90 mmHg, 76 (18.1%) of the 420 hypertensives were white coat hypertensives (WCHs) and 344 were established hypertensives (EHs). With a lower cutoff of 135/ 85 mmHg, 40 (9.5%) were WCHs. Complete follow-up data were obtained for all 566 subjects. The mean duration of follow-up was 10.2 years (range 9.0-12.5).In the WCH group, 14 first events were recorded (18.4%) consisting of two cardiovascular deaths and 12 nonfatal cardiovascular events. In the EH group, the corresponding number of events were 56 first events (16.3%), 12 cardiovascular deaths and 44 nonfatal cardiovascular events, and in the NT group 10 first events (6.8%), two cardiovascular deaths and eight nonfatal cardiovascular events. The event rate was similar in the WCH group and the EH group and significantly lower in the NT group (Po0.05). When corrected for daytime-ABP, age and other confounders, the difference remained statistically significant. When using the lower cutoff of 135/ 85 mmHg, WCH was still associated with a significantly higher cardiovascular event rate. In conclusion, the main finding of this 10-year follow-up study is an increased cardiovascular risk in WCH compared to normotensive controls.

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Section: -Year Follow-up Of Wchsupporting

confidence: 91%

Section: -Year Follow-up Of Wchcontrasting

confidence: 63%

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White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study

Gustavsen¹,

Høegholm²,

Bang³

et al. 2003

J Hum Hypertens

172

117

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“…All evaluations were performed in the same batch; hence, the readings were different from the data previously reported. 21 The reason for the blinding procedure was to assure an estimate free from bias, but of course at the cost of lower accuracy which, however, is of less importance due to the relatively high number of subjects. No patient was excluded from analysis because of difficulties in obtaining images, although 55 (11.4%) were considered of minor technical quality.…”

Section: Echocardiographymentioning

confidence: 99%

White coat hypertension and target organ involvement: the impact of different cut-off levels on albuminuria and left ventricular mass and geometry

Høegholm¹,

Ks²,

Le³

et al. 1998

J Hum Hypertens

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The aim of this cross-sectional study which took place in a hypertension clinic at a district general hospital in Denmark was to make a pragmatic definition of white coat hypertension. A total of 420 patients were referred consecutively from general practice with newly diagnosed untreated essential hypertension and 146 normal subjects were drawn at random from the Danish national register. The following measurements were taken: office blood pressure; 24-h ambulatory blood pressure (BP) monitoring; echocardiography with determination of left ventricular mass index and relative wall thickness; and early morning urine albumin/creatinine ratios.Four different cut-off levels were studied. An ambul-

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“…1,2 The prognosis for whitecoat hypertensive subjects is not yet completely clear. [3][4][5][6][7][8][9][10][11][12][13] Some studies have shown that white-coat hypertension is a benign condition, 3,5,6,10,12,13 whereas others have not. 4,[7][8][9]11 We have reported recently that subjects with white-coat hypertension do not show target organ damage and present a lipid profile similar to that in normotensive subjects, 14 suggesting that they could be considered at low cardiovascular risk.…”

mentioning

confidence: 99%

Low-Density Lipoprotein Oxidation and Vitamins E and C in Sustained and White-Coat Hypertension

et al. 1998

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Abstract-Low-density lipoprotein oxidation and antioxidant vitamins E and C were investigated in white-coat hypertension in comparison with sustained hypertension and normotension. We selected 21 sustained hypertensive subjects, 21 white-coat hypertensive subjects, and 21 normotensive subjects matched for gender, age, and body mass index. White-coat hypertension was defined as clinical hypertension and daytime ambulatory blood pressure Ͻ139/90 (subjects were also reclassified using 134/90 and 135/85 mm Hg as cutoff points for daytime blood pressure). Blood samples were drawn for lipid profile determination, assessment of fluorescent products of lipid peroxidation in native LDL, evaluation of susceptibility to LDL oxidation in vitro (lag phase and propagation rate), and determination of LDL vitamin E and plasma vitamins E and C contents. 3-13 Some studies have shown that white-coat hypertension is a benign condition, 3,5,6,10,12,13 whereas others have not. 4,[7][8][9]11 We have reported recently that subjects with white-coat hypertension do not show target organ damage and present a lipid profile similar to that in normotensive subjects, 14 suggesting that they could be considered at low cardiovascular risk.Several lines of evidence suggest that hypertension is associated with enhanced oxidative stress, 15-23 although it is not yet clear whether this phenomenon occurs before or after the development of hypertension. An important consequence of increased oxidative stress is LDL oxidation. It has been suggested that beyond the known risk markers for cardiovascular disease, oxidation of LDL could play an important role in the development 24 and progression 25 of atherosclerosis. Moreover, it may contribute to the maintenance of hypertension. 26 -29 It has been reported that LDL is more oxidized in vivo and is more susceptible to oxidation in vitro in hypertensive patients than in normotensive subjects. 30 -32 In such a context, vitamins C 33 and E 34 represent the major antioxidants in the water-and lipid-soluble compartments, respectively, and they are devoted to protect against oxidative damage. To the best of our knowledge, no study apparently has evaluated whether sustained and white-coat hypertensives show differences in LDL oxidation and antioxidant vitamins.The present study was designed to investigate LDL oxidation, evaluating fluorescent products of lipid peroxidation in native lipoproteins and susceptibility to oxidation in vitro, and antioxidant vitamins E and C in subjects with white-coat hypertension compared with subjects with normotension and those with sustained hypertension. Methods SubjectsWe selected 21 normotensive, 21 white-coat hypertensive (see below for definition), and 21 sustained hypertensive subjects matched for gender, age, and body mass index. Exclusion criteria for entry in the study were smoking habits, diabetes mellitus, hypercholesterolemia (Ͼ5.7 mmol/L), hypertriglyceridemia (Ͼ2.9 mmol/L), antihypertensive and lipid-lowering drug use (present or past), antioxidant sub-

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Left Ventricular Mass and Geometry in Patients With Established Hypertension and White Coat Hypertension

Cited by 79 publications

References 0 publications

White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study

White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study

White coat hypertension and target organ involvement: the impact of different cut-off levels on albuminuria and left ventricular mass and geometry

Low-Density Lipoprotein Oxidation and Vitamins E and C in Sustained and White-Coat Hypertension

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