Long-Term Risk of Progression to Sustained Hypertension in White-Coat Hypertension with Normal Night-Time Blood Pressure Values

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Joaquim Luís Faria (Author) FEUP; Bastos, JM (Author) Other; Bertoquini, S (Author) Other; Silva, J (Author) Other; Polonia, J (Author) FMUP

Journal

Title: International Journal of Hypertension

Vol. 2020

ISSN: 2090-0384

Publisher: Hindawi

Indexing

ISI Web of Knowledge - 3 Citations

Scopus - 5 Citations

Other information

Authenticus ID: P-00T-9PA

DOI: 10.1155/2020/8817544

Abstract (EN): Background. The long-term prognosis and transition towards sustained ambulatory hypertension (SHT) of white-coat hypertension (WCHT) remain uncertain particularly in those with both normal nighttime and daytime blood pressure (BP) values. Different classification criteria and the use of antihypertensive drugs may contribute to conflicting results. Patients and Methods. We prospectively evaluated for a 7.1 year transition to SHT in 899 nondiabetic subjects free from cardiovascular (CV) events: normotensive (NT) (n = 344; 52, 9% female; ageing 48 +/- 14 years); untreated WCHT (UnWCHT n = 399; 50, 1% female; ageing 51 +/- 14 years); and treated WCHT with antihypertensive drugs after baseline (TxWCHT n = 156; 54, 4% female; ageing 51 +/- 15 years). All underwent 24 h ambulatory BP monitoring (24 h-ABPM) at baseline, at 30 to 60 months, and at 70 to 120 months thereafter. WCHT was at baseline (with no treatment) as office BP >= 140/or 90 mm center dot Hg, daytime BP < 135/85 mm center dot Hg, and nighttime BP < 120/70 mm center dot Hg. Development of SHT was considered if daytime BP >= 135/or 85 mm Hg and/or nighttime BP >= 120/or 70 mm center dot Hg. Results. Baseline metabolic parameters did not differ among groups. At 30-60 months and at the end of follow-up, development of SHT occurred, respectively, in NT (3.8% (n = 13) and 9.6% (n = 33)) and in UnWCHT (10.1% (n = 40) and 16.5% (n = 66)) (p<0.009). The mean annual increase of average 24 h-systolic BP was 0.48 + 0.93 in NT and 0.73 + 1.06 in UnWCHT, whereas annual SBP in office increased in NT by 1.2 + 0.95 but decreased in UnWCHT by 1.36 + 1.35 mm Hg (p<0.01). Conclusion. Untreated WCHT patients exhibit a faster and a higher risk of developing SHT compared to NT with TxWCHT assuming an intermediate position between them.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8