The white coat effect is not associated with additional increase of target organ damage in true resistant hypertension

Background and objective: White coat effect (WCE) (i.e., the difference between office blood pressure [OBP] and awake ambulatory blood pressure monitoring [ABPM]) may be present in hypertensive individuals. The relationship between occurrence of WCE and target organ damage (TOD) has not yet been assessed in true resistant hypertension (RHTN). Patients and methods: RHTN patients were divided into two groups: RHTN with WCE (WCE, n=66) and RHTN without WCE (non-WCE, n=61). All patients were submitted to OBP measurement, ABPM, echocardiography and renal function evaluation in three visits. Results: No differences were observed between the WCE and non-WCE groups regarding age, body mass index or gender. OBP were 169.8±15.8/95.1±14.0 (WCE) and 161.9±9.0/90.1±10.4mmHg (non-WCE), ABPM=143.0±12.8/86.1±9.9 (WCE) and 146.1±13.6/85.1±14.9mmHg (non-WCE). No statistical differences were observed between WCE and non-WCE subgroups with respect to left ventricular mass index (LVMI) (WCE=131±4.7; non-WCE=125±2.9g/m2), creatinine clearance (WCE=78±4.7; non-WCE=80±3.6ml/min/m2) and microalbuminuria (MA) (WCE=44±8.4; non-WCE=49±6.8mg/g Cr). Conclusions: This finding may suggest that WCE is not associated with additional increase of TOD in true RHTN subjects (AU)

Fundamento y objetivo: El efecto de bata blanca (EBB), es considerado cuando la diferencia entre la PAS/PAD medida en consulta médica y aquella obtenida por monitorización ambulatoria de la presión arterial (MAPA) y puede estar presente durante la consulta médica en pacientes con hipertensión arterial resistente (HTA-R). La relación entre la presencia del efecto bata blanca y daños en órganos diana aún no ha sido evaluada en individuos con HTA-R verdadera. Pacientes y método: En este estudio, sesenta y seis pacientes con HTA-R verdadera presentaron EBB y otros 61 no lo hicieron. A todos los sujetos se les practicó una monitorización ambulatoria de la presión arterial durante 24 horas (MAPA). La afectación de órganos diana se determinó mediante la realización de ecocardiograma y evaluación de la función renal. Resultados: Los valores de PAS y PAD en consulta médica fueron: 169,8±15,8/95,1±14,0 (pacientes con EBB) y 161,9±9,0/90,1±10,4mmHg (pacientes sin EBB), respectivamente y mediante MAPA los valores promedios de PAS y PAD de 24 horas fueron: 143,0±12,8/86,1±9,9 (pacientes con EBB) y 146,1±13,6/85,1±14,9 mmHg (pacientes sin EBB), respectivamente. No se observaron diferencias significativas entre los pacientes con o sin EBB con respecto al índice de masa ventricular izquierda (con EBB=131±4,7; sin EBB=125±2,9g/m2), aclaramiento de creatinina (con EBB=78±4,7; sin EBB=80±3,6ml/min/m2) y microalbuminuria (con EBB=44±8,4; sin EBB=49±6,8mg/g Cr). Conclusiones: Este hallazgo sugiere que el EBB no se asocia a incremento adicional de daños en órganos diana en pacientes con HTA-R verdadera (AU)

The white coat effect is not associated with additional increase of target organ damage in true resistant hypertension.

BACKGROUND AND OBJECTIVE: White coat effect (WCE) (i.e., the difference between office blood pressure [OBP] and awake ambulatory blood pressure monitoring [ABPM]) may be present in hypertensive individuals. The relationship between occurrence of WCE and target organ damage (TOD) has not yet been assessed in true resistant hypertension (RHTN). PATIENTS AND METHODS: RHTN patients were divided into two groups: RHTN with WCE (WCE, n=66) and RHTN without WCE (non-WCE, n=61). All patients were submitted to OBP measurement, ABPM, echocardiography and renal function evaluation in three visits. RESULTS: No differences were observed between the WCE and non-WCE groups regarding age, body mass index or gender. OBP were 169.8±15.8/95.1±14.0 (WCE) and 161.9±9.0/90.1±10.4mmHg (non-WCE), ABPM=143.0±12.8/86.1±9.9 (WCE) and 146.1±13.6/85.1±14.9mmHg (non-WCE). No statistical differences were observed between WCE and non-WCE subgroups with respect to left ventricular mass index (LVMI) (WCE=131±4.7; non-WCE=125±2.9g/m(2)), creatinine clearance (WCE=78±4.7; non-WCE=80±3.6ml/min/m(2)) and microalbuminuria (MA) (WCE=44±8.4; non-WCE=49±6.8mg/g Cr). CONCLUSIONS: This finding may suggest that WCE is not associated with additional increase of TOD in true RHTN subjects.