Research Article
Volume 8 Issue 3 - 2021
Sequential Follow-Up Evaluation of Morning Surge and Pulse Wave Velocity in White-Coat Hypertensive Patients with Normal Nighttime Blood Pressure
João Faria1, José Mesquita Bastos2, Susana Bertoquini3, José Silva3, Loide Barbosa3 and Jorge Polónia1*
1Department Medicine and Cintesis, Faculty of Medicine, University of Porto, Porto, Portugal
2Health School of Aveiro University, Aveiro, Portugal
3Hypertension Unit, Hospital Pedro Hispano, ULS, Matosinhos, Portugal
*Corresponding Author: Jorge Polónia, Professor, Department Medicine and Cintesis, Faculty of Medicine, University of Porto, Porto, Portugal.
Received: December 18, 2020 Published: February 16, 2021




Abstract

Prognosis and damage or cardiovascular (CV) target organ of white-coat hypertension (WCH) is a subject of controversy. We evaluated at baseline (BL) and between 37 - 150 months of follow-up (FU) a cohort of 452 outpatients non-diabetics free of previous CV events including normotensives (NT, n = 101, 50 ± 11 yrs, 60% female, office BP < 140/90 mmHg and normal daytime BP (< 135/85 mm Hg) and nighttime BP < 120/70 mm Hg), untreated WCHT (n = 254, 45 ± 14 yrs, 62% female, normal daytime and nighttime BP) and hypertensives HT (n = 97, 54 ± 7 yrs, 58% female) the morning BP surge and the aortic stiffness (pulse wave velocity - PWV) as markers of organ damage and CV prognosis. At BL office and 24h BP (mm Hg) were respectively in NT 126/82 + 9/10 and 24h 118/73 + 7/6, in WCHT 150/91 + 8/8 and 24h 120/74 + 5/6 and in HT 152/97 + 11/9 and 24h 135/83 mm Hg. CV event rates per 100 patients-years were 0.61 in WCH, 0.66 in NT and 2.2 in HT groups with a relative risk of 4.12 (CI 95% 2.99 - 6.69) in HTs than in WCH and NT. At BL and at the end of the FU morning surge of BP (mm Hg) was higher (p < 0.01) in the HT group (BL 34 ± 20; FU 35 ± 21) than NT (BL 22 ± 10; FU 26 ± 11) and WCH (BL 25 ± 12; FU 27 ± 12). PWV (m/s) was similar at both phases between NT (9.6 ± 1.9) and WCH (9.7 ± 2.2) but significantly higher (p < 0.01) in HT (10.9 ± 3.2) vs NT and WCH. We conclude that WCH with normal nighttime BP has a relative benign prognosis and similar target organ damage vs normotensives. Thus, nighttime BP should be included in the WCHT definition and in its prognostic stratification.

Keywords: White-Coat Hypertension; Normal Nighttime Blood Pressure, Transition to Sustained Hypertension

References

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Citation: Jorge Polónia., et al. “Sequential Follow-Up Evaluation of Morning Surge and Pulse Wave Velocity in White-Coat Hypertensive Patients with Normal Nighttime Blood Pressure”. EC Cardiology 8.3 (2021): 01-03.

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