Relations between white coat effect of blood pressure and arterial stiffness

J Clin Hypertens (Greenwich). 2022 Nov;24(11):1427-1435. doi: 10.1111/jch.14573. Epub 2022 Sep 22.

Abstract

The aim of this study was to analyze the relationship between brachial-ankle pulse wave velocity (b-a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP, in a mixed population of normotention, untreated sustained hypertension, sustained controlled hypertension, sustained uncontrolled hypertension, white coat hypertension, white coat uncontrolled hypertension. A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86 ± 13.3 years) were enrolled in the study. Patients were separated into low WCE (<9.5 mm Hg) and high WCE (≥9.5 mm Hg) according to the median of WCE. The subjects with a high WCE showed a greater degree of arterial stiffness than those with a low WCE for systolic BP values (P < .05). The b-a PWV were 17.2 ± 3.3 m/s and 18.4 ± 3.4 m/s in low WCE and high WCE, respectively. The b-a PWV increased with the increase of WCE, showing a positive correlation between them (P > .05 for non-linearity). The significant association between the high WCE and the b-a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors (β = .78, 95% Cl .25-1.31, P = . 004). Similar results were observed in subgroups. In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.

Keywords: PWV; arterial stiffness; target organ damage; white coat effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory
  • Female
  • Humans
  • Hypertension* / complications
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Vascular Stiffness*
  • White Coat Hypertension* / complications
  • White Coat Hypertension* / diagnosis
  • White Coat Hypertension* / epidemiology