|
 |
Article Review/Hyperlink
|
Glen SK, Elliott HL, Curzio JL, Lees KR, Reid JL
White-coat hypertension as a cause of cardiovascular
dysfunction
Lancet
(Sep) 348:654-657 1996

This is another cross-sectional study which tries to address the issue
of whether white-coat hypertension is an innocuous condition. Although
most of the available study indicate that it is likely to be benign in
the short term, several groups have suggested that such patients are
truly hypertensive.
Study design
The authors matched three groups of subjects acording to age, sex and
other demographics. They defined the groups as follows:
Group
Office BP (mmHg) Daytime BP (mmHg)
Normotensive < 95 < 95
White-coat > 95 < 95
Hypertensive > 95 > 95
They then studied diastolic function of the heart (correcting for BP
at the time of measurement) as well as large artery compliance (also
corrected). All subjects had to be off antihypertensive therapy for at
least 4 weeks.
Results
The results showed that left ventricular mass was similar in
normotensives as in white-coat hypertensives and lower than sustained
hypertensives. They also found that the E/A ratio was lower in both
white-coat and sustained hypertensives than in normotensives. They
also found that there was reduced arterial elasticity in the
white-coat and hypertensive groups compared to the normotensive
groups.
Comment: The value of this study is limited by the definition
used by the authors of the three groups. It is clear that the patients
included in the white-coat group would be considered hypertensive
(e.g. office DBP 96 mmHg and daytime DBP 94 mmHg) by many observers
and treated and that the normotensive group also may include patients
that would be labeled hypertensive (e.g. office DBP 94 mmHg, daytime
DBP 94 mmHg). Unfortunately, clear separation of the three groups was
not attained. Furthermore, the effects of recent antihypertensive
therapy on arterial elasticity and diastolic function need to be
accounted for. Thus previous therapy is a potential confounder in this
study since patients were only off antihypertensive therapy for four
weeks. The findings in this study re-emphasize that a consensus is
needed about the definition of white-coat hypertension. The present
study could have found entirely different results if the three groups
were better separated.
(George Mansoor, M.D., University of Connecticut)
The full text of this abstract is available
at the Lancet site. The first time you access the Lancet site, you will need
to register to get a login ID and password. Then you can read the full text
full text.
Accompanying this paper for print in
pdf.
Related Folders: |
 |
|
|
|
|