White-Coat Isolated Systolic Hypertension Is a Risk Factor for Carotid Atherosclerosis

J Clin Hypertens (Greenwich). 2016 Nov;18(11):1095-1102. doi: 10.1111/jch.12888. Epub 2016 Aug 2.

Abstract

The clinical importance of white-coat hypertension (WCH) remains a controversial issue. The aim of this study was to evaluate the association of isolated systolic, isolated diastolic, and systolic/diastolic WCH with common carotid artery intima-media thickness (CCA-IMT) and to compare each subgroup of WCH against other blood pressure (BP) phenotypes in terms of CCA-IMT values. A total of 1382 consecutive patients underwent 24-hour ambulatory BP monitoring and carotid artery ultrasonographic measurements. According to the type of elevated office BP, WCH was divided into three groups: isolated systolic, isolated diastolic, and systolic/diastolic WCH. Patients with isolated systolic WCH (n=112) had significantly higher CCA-IMT values (0.737 mm) than those with isolated diastolic WCH (n=66) (0.685 mm) and nonsignificantly greater compared with those with systolic/diastolic WCH (n=228) (0.708 mm). Patients with isolated systolic WCH had CCA-IMT values similar to those with hypertension, patients with isolated diastolic WCH had similar values to those with normotension, and patients with systolic/diastolic WCH had an intermediate risk between normotension and hypertension.

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Intima-Media Thickness
  • Female
  • Humans
  • Male
  • Middle Aged
  • White Coat Hypertension / classification*
  • White Coat Hypertension / complications