Maseko Muzi J, Woodiwiss Angela J, Libhaber Carlos D, Brooksbank Richard, Majane Olebogeng H I, Norton Gavin R
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Scienes, University of the Witwatersrand, Johannesburg, South Africa;
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Scienes, University of the Witwatersrand, Johannesburg, South Africa; School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Am J Hypertens. 2013 Nov;26(11):1287-94. doi: 10.1093/ajh/hpt108. Epub 2013 Aug 7.
Whether independent relationships between white coat effects (office minus day (office-day blood pressure (BP))) and organ damage or arterial stiffness may be explained by associations with an attenuated nocturnal BP dipping, has not been determined.
In 750 participants from a sample of African ancestry, office and 24-hour BP, carotid-femoral pulse wave velocity (PWV) (applanation tonometry and SphygmoCor software) (n = 662), and left ventricular mass indexed to height(2.7) (LVMI) (echocardiography) (n = 463) were determined.
Office-day systolic BP (SBP) was correlated with day minus night (day-night) SBP, percentage night divided by day (night/day) SBP, and night SBP (P < 0.0005), and these relationships persisted with adjustments for confounders, including day SBP (P < 0.005). With adjustments for 24-hour SBP and additional confounders, office-day SBP was associated with LVMI (P < 0.01) and PWV (P < 0.0001). With adjustments for day SBP and additional confounders, day-night SBP, percentage night/day SBP, and night SBP were related to PWV (P < 0.05) but not to LVMI (P > 0.44). The relationships between office-day SBP and LVMI or PWV persisted with adjustments for either day-night or percentage night/day SBP (LVMI: P = 0.01; PWV: P < 0.0001) or night SBP (LVMI: P < 0.01; PWV: P = 0.0001), and in product of coefficient mediation analysis with appropriate adjustments, neither indexes of nocturnal BP dipping nor nocturnal BP per se contributed toward the impact of office-day BP on LVMI or PWV (P > 0.09).
In a group of African ancestry, although white coat effects are independently associated with an attenuated nocturnal decrease in SBP, neither decreased BP dipping nor nocturnal BP contribute toward the independent relationships between white coat effects and LVMI or arterial stiffness.
白大衣效应（诊室血压减去日间血压（诊室 - 日间血压（BP）））与器官损害或动脉僵硬度之间的独立关系是否可由与夜间血压下降减弱的关联来解释，尚未确定。
在750名非洲裔样本参与者中，测定了诊室血压和24小时血压、颈股脉搏波速度（PWV）（压平式眼压计和SphygmoCor软件）（n = 662）以及身高平方体质量指数（LVMI）（超声心动图）（n = 463）。
诊室 - 日间收缩压（SBP）与日间减去夜间（日间 - 夜间）SBP、夜间除以日间（夜间/日间）SBP百分比以及夜间SBP相关（P < 0.0005），并且在对包括日间SBP在内的混杂因素进行调整后，这些关系依然存在（P < 0.005）。在对24小时SBP和其他混杂因素进行调整后，诊室 - 日间SBP与LVMI（P < 0.01）和PWV（P < 0.0001）相关。在对日间SBP和其他混杂因素进行调整后，日间 - 夜间SBP、夜间/日间SBP百分比以及夜间SBP与PWV相关（P < 0.05），但与LVMI无关（P > 0.44）。在对日间 - 夜间或夜间/日间SBP百分比（LVMI：P = 0.01；PWV：P < 0.0001）或夜间SBP（LVMI：P < 0.01；PWV：P = 0.0001）进行调整后，诊室 - 日间SBP与LVMI或PWV之间的关系依然存在，并且在进行适当调整的系数乘积中介分析中，夜间血压下降指数和夜间血压本身均未对诊室 - 日间血压对LVMI或PWV的影响产生作用（P > 0.09）。
在一组非洲裔人群中，尽管白大衣效应与夜间SBP下降减弱独立相关，但血压下降减弱和夜间血压均未对白大衣效应与LVMI或动脉僵硬度之间的独立关系产生作用。
