RESUMO
OBJECTIVES: The risk profile of white-coat hypertension/effect (WCH/E) remains unclear. This study aimed to investigate the relationship between WCH/E, markers of cardiovascular risk and cerebrovascular events. METHODS: This is a sub-group analysis of The Arterial Stiffness In lacunar Stroke and Transient ischemic attack (ASIST) study, which recruited 96 patients aged at least 40 years old with a diagnosis of transient ischemic attack or lacunar stroke in the preceding 14âdays. Thirty-two patients with target blood pressure (clinic blood pressure <140/90âmmHg and daytime ambulatory blood pressure <135/85âmmHg) and 30 patients with WCH/E (clinic blood pressure ≥140/90âmmHg and daytime ambulatory blood pressure <135/85âmmHg) were included in the analysis. RESULTS: Patients with WCH/E were older and had a higher BMI. Central SBP (145â±â13 vs. 118â±â8âmmHg, Pâ<â0.001) and DBP (82â±â8 vs. 76â±â7âmmHg, Pâ=â0.004) were higher in those with WCH/E. They also had higher arterial stiffness measured by carotid-femoral pulse wave velocity (11.9â±â3.0 vs. 9.6â±â2.3âm/s, Pâ=â0.002) and cardio-ankle vascular index (10.3â±â1.3 vs. 9.4â±â1.7, Pâ=â0.027). Regression analysis showed an independent relationship between WCH/E and both measures of arterial stiffness. Lacunar strokes were more prevalent in those with WCH/E (47 vs. 22%, Pâ=â0.039) and individuals in this group were more likely to have had a lacunar stroke than a transient ischemic attack (odds ratio 9.6, 95% CI 1.5-62.6, Pâ=â0.02). CONCLUSION: In this cohort of patients with lacunar stroke and transient ischemic attack, WCH/E was associated with elevated markers of cardiovascular risk and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.