White-coat hypertension and arterial stiffness

Abstract

The objective of our work was to study the relationship between White-coat hypertension (WCT) and vascular dysfunction in a general non-diabetic population. We included patients between the ages of 30 and 70. They all benefited from a clinical and biological assessment. Blood pressure was measured in consultation, and at home by an ambulatory blood pressure monitoring (ABPM) by Tonoport V GE®. We performed a measurement of the carotido-femoral pulse wave velocity (cfPWV) (Sphygmocor®), a search for carotid atherosclerotic plaque (CAP), and an Ankle-Brachial Index (ABI). We have adopted the recommendations of the European Societies of Cardiology and High Blood Pressure to retain the diagnosis of WCT (a consultation BP ≥ 140/90 mmHg and an average BP of 24 hours < 135/85 mmHg). Statistics: SPSS 21.0 software. In total, 333 participants aged 46.8 ± 9.9 years were included [170 women (51.1%)]. The average consultation BP was 128.8 ± 17.7/77.7 ± 7.0 mmHg. In ABPM, the average 24-hour BP: 125.5 ± 11.90/117.4 ± 78.8 mmHg, daytime: 129.0 ± 12.1/82.1 ± 9.9 mmHg, and nocturnal: 115.9 ± 13.2/68.7 ± 9.6 mmHg; 16.8% ( n = 56) WCT, 43.5% ( n = 145) normo tension (NT), 25.2% ( n = 84) masked hypertension (MHT), 14.4% ( n = 48) confirmed hypertension (cHT). The average cfPWV of WCT patients (9.6 ± 2.4 m/s) was higher than that of the NT (8.5 ± 2.3 m/s), P = 0.007, and not statistically different from that of the MHT (9.36 ± 2.7 m/s, P = 0.5), and the cHT (10.7 ± 3.3 m/s, P = 0.06). CAPs were present at 6.9% NT, 26.8% WCT, 19% MHT, 20.8% cHT, respectively, P < 0.001. An ABI ≤ 0.9 was rated in 0.7% NT, 5.4% WCT, 6% MHT, and 16.7% cHT, P < 0.01. In multivariate analysis, MHT and fatty liver disease were the independent factors associated with high cfPWV (≥ 10 m/s). The results of our study suggest that people with WCT have higher cfPWV than normotensive people. However, this WCT does not appear to be an independent factor associated with high arterial stiffness.