Masked hypertension in subjects with job stress

Abstract

Objective. To estimate target organs state and endothelial function in patients with isolated ambulatory hypertension at work. Design and methods. 76 patients with hypertension at working place (AHwp) formed the 1st group, 42 patients with fi rstly diagnosed essential hypertension formed the 2nd group. Offi ce blood pressure (BP) was measured in all subjects. Also BP monitoring at work and at rest, echocardiography, duplex scanning of brachiocephal arteries, test of brachial artery temporary occlusion and endothelial function assessment were performed. Results. Patients of the 1st and 2nd groups had comparable risk factors. Patients with AHwp 24,1 % (p = 0,01) oftener showed diastolic dysfunction of left ventricle (LV). Intima-media thickness did not differ between groups but atheroma was found more frequently (for 13,2 %, p = 0,01) in subjects from the 1st group. Subjects with AHwp in comparison with those with essential hypertension rarely had normal endothelial function (for 26,1 %, p = 0,005), vasoconstrictive endothelial reaction on temporary occlusion was found oftener (for 30,3 %, p = 0,001) in 1st group subjects. Conclusions. Patients with masking hypertension had comparable rate of main risk factors, LV hypertrophy and brachiocephal atherosclerosis, but they showed more expressed diastolic dysfunction of LV and endothelial dysfunction as compared to patients with essential hypertension.