White coat hypertension is another clinical characteristic of patients with inflammatory bowel disease: A cross-sectional study

Abstract

In this cross-sectional study, our aim was to analyze association of ambulatory blood pressure monitoring (ABPM) values with pulse wave velocity (PWV) in inflammatory bowel disease (IBD) patients as well as the prevalence and characteristics of white coat hypertension (WCH) in this group of patients with chronic inflammation and high prevalence of anxiety. We enrolled 120 consecutive IBD patients (77 Crohn´s disease; 43 ulcerative colitis) who were not treated with antihypertensive drugs without cardiovascular, cerebrovascular and renal morbidity. Office blood pressure, ABPM, and PWV were measured with Omrom M6, SpaceLab 90207, and Arteriograph, respectively. The prevalence of true normotension, sustained hypertension and WCH was analyzed in IBD patients. WCH was found in 27.5% patients. IBD-WCH patients had significantly lower prevalence of traditional risk factors than general WCH subjects. PWV and augmentation index (AIx) values were higher in WCH than in true normotensive patients. When adjusted for age and duration of IBD, only PWV was a positive predictor of WCH, and patients with higher PWV and longer disease duration had OR´s for WCH of 0.69 and 2.50, respectively. IBD patients had significantly higher prevalence of WCH and higher PWV values than healthy control patients. WCH is highly prevalent in IBD patients but IBD-WCH patients have lower frequency of traditional cardiovascular risk factors than general WCH population. Our results suggest that WCH could be considered as another clinical characteristic of IBD which is associated with increased arterial stiffness and those patients should be monitored more closely.Abbreviations: ABPM = ambulatory blood pressure monitoring, AIx = augmentation index, BP = blood pressure, CKD = chronic kidney disease, CV = cardiovascular, eGFR = estimated glomerular filtration rate, IBD = inflammatory bowel disease, PWV = pulse wave velocity, WCH = white coat hypertension.

Arterial stiffness in prehypertensive patients with white coat hypertension

“…A study on 120 patients with inflammatory bowel disease (IBD) by Premužić et al found that a significantly higher proportion of IBD patients with white coat hypertension had PWV values above the 8 m/s cutoff when compared to true normotensive IBD patients (84.8 vs 30.6, p < 0.001). Furthermore, IBD patients with white coat hypertension had significantly higher values of central SBP and central puls pressure when compared to true normotensive IBD patients, while having similar (nonsignificantly different) age, gender distribution, smoking status, duration of IBD, biochemical data, proportion of patients receiving biological or immunosuppressive treatment (11). Research by Stolarz et al compared PWV in a random sample of participants with either normotension, masked hypertension or white coat hypertension and found significantly higher values of PWV in patients with white coat hypertension when compared to those with true normotension (9.39+/-1.23 m/s vs 8.56+/-1.45 m/s; p < 0.05).…”