Abstract P216: Association Between White-coat Hypertension and Arterial Stiffness: a Systematic Review and Meta-analysis

Abstract

Background: Previous studies have shown inconclusive effects of target organ damage from white-coat hypertension (WCHT). Arterial stiffness is involved in the atherosclerotic processes in the setting of sustained hypertension. This meta-analysis aimed to compare arterial stiffness in subjects with diagnosis of WCHT to subjects with normotension (NT) and SHT. Methods: A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through May 2016. The inclusion criterion was the observational studies’ assessment of the association between WCHT and NT or SHT in adult subjects. European Society of Hypertension practice guidelines for ambulatory blood pressure (BP) monitoring was used to define WCHT (office BP≥140/90mmHg and daytime BP <135/85mmHg), and SHT (office BP≥140/90mmHg and daytime BP≥135/85mmHg). Aortic stiffness was assessed using Carotid-femoral pulse wave velocity (PWV) measurements. Pooled mean difference (MD) of PWV and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Data were extracted from 4 observational studies involving 2,413 subjects. PWV is not different in patients with WCHT compared with SHT (pooled MD= -0.25 m/sec; 95% CI, -0.81 to 0.30; P-value=0.37, I 2 =74%). PWV in WCHT is also not different when compared with PWV in NT (MD= 0.86 m/sec; 95% CI, -0.30 to 2.03; P-value=0.15, I 2 =97%). Conclusion: In a meta-analysis, we observe that arterial stiffness measured by pulse wave velocity is not different in patients with white-coat hypertension when compared with sustained hypertension or normotension.