Saunders, Alec, Nuredini, Gani N, Kirkham, Frances A, Drazich, Erin, Bunting, Eva, Rankin, Philip, Ali, Khalid, Okorie, Michael and Rajkumar, Chakravarthi (2022) White-coat hypertension/effect is associated with higher arterial stiffness and stroke events. Journal of Hypertension, 40 (4). pp. 758-764. ISSN 0263-6352

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Abstract

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 14 days. Thirty-two patients with target blood pressure (clinic blood pressure <140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) and 30 patients with WCH/E (clinic blood pressure ≥140/90 mmHg and daytime ambulatory blood pressure <135/85 mmHg) were included in the analysis.

Results:
Patients with WCH/E were older and had a higher BMI. Central SBP (145 ± 13 vs. 118 ± 8 mmHg, P < 0.001) and DBP (82 ± 8 vs. 76 ± 7 mmHg, P = 0.004) were higher in those with WCH/E. They also had higher arterial stiffness measured by carotid–femoral pulse wave velocity (11.9 ± 3.0 vs. 9.6 ± 2.3 m/s, P = 0.002) and cardio-ankle vascular index (10.3 ± 1.3 vs. 9.4 ± 1.7, P = 0.027). 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%, P = 0.039) 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, P = 0.02).

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.

Item Type:	Article
Keywords:	Adult, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Humans, Hypertension, Pulse Wave Analysis, Stroke, Vascular Stiffness, White Coat Hypertension
Schools and Departments:	Brighton and Sussex Medical School > Clinical and Experimental Medicine Brighton and Sussex Medical School > Division of Medical Education
SWORD Depositor:	Mx Elements Account
Depositing User:	Mx Elements Account
Date Deposited:	26 Apr 2022 06:46
Last Modified:	07 Jan 2023 02:00
URI:	http://sro.sussex.ac.uk/id/eprint/105502

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