Psychophysiological Reactivity and Cardiac End‐Organ Changes in White Coat Hypertension
作者:
Carmine Cardillo,
Francesco De Felice,
Umberto Campia,
Giuseppe Folli,
期刊:
Hypertension
(OVID Available online 1993)
卷期:
Volume 21,
issue 6, Part 1
页码: 836-844
ISSN:0194-911X
年代: 1993
出版商: OVID
关键词: stress, psychological;exercise test;blood pressure;ventricular mass;ventricular function
数据来源: OVID
摘要:
This study aimed 1) to assess whether patients with an exaggerated blood pressure response to the doctor's presence (“white coat” effect) also display a pattern of enhanced blood pressure reactivity to mental stress and physical exercise and 2) to determine the presence of left ventricular structural and filling abnormalities in patients with white coat hypertension. We studied 56 (40 men) consecutive patients (mean [SD] age, 46.4 [9.1] years) whose clinic blood pressure was repeatedly high. Patients were classified as having white coat hypertension (n=20) if both their mean daytime (from 7 AM to 11 PM) ambulatory systolic and diastolic blood pressures were less than 134 and 90 mm Hg, respectively. Patients were considered to have persistent hypertension (n=36) if daytime systolic blood pressure was 134 mm Hg or more or diastolic blood pressure was 90 mm Hg or more. Eighteen subjects with clinic blood pressure lower than 140/90 mm Hg served as a normotensive control group. Blood pressure reactivity from baseline to mental arithmetic, isometric handgrip, and cycle ergometry did not display any difference among the three groups. The white coat hypertensive group had left ventricular mass index lower than the persistent hypertensive group but higher than the normotensive group. Doppler indexes of left ventricular diastolic filling displayed similar abnormalities in the white coat and persistent hypertensive groups compared with the normotensive group. We conclude that 1) we cannot distinguish white coat hypertensive patients by a pattern of blood pressure hyperreactivity to mental and physical laboratory tasks, and 2) white coat hypertension is characterized by mild cardiac enlargement and shares with persistent hypertension similar abnormalities in left ventricular filling. These latter findings suggest that white coat hypertension may not be considered an entirely innocuous clinical condition.
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