Androulakis Emmanuel, Papageorgiou Nikolaos, Lioudaki Eirini, Chatzistamatiou Evaggelos, Zacharia Effimia, Kallikazaros Ioannis, Tousoulis Dimitris
Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK.
Barts Heart Centre, St Bartholomew's Hospital, London, UK.
J Clin Hypertens (Greenwich). 2017 Feb;19(2):190-197. doi: 10.1111/jch.12882. Epub 2016 Jul 21.
The authors investigated the relationship of white-coat hypertension (WCH) with subclinical organ damage and potential relevant mechanisms. A total of 386 untreated patients were enrolled and divided into 204 patients with WCH and 183 with normotension. Flow-mediated dilation (FMD), pulse wave velocity (PWV), intima-media thickness, left ventricular mass index (LVMI), and cystatin C levels were measured. All tests were two-sided, and a P value <.05 was considered statistically significant. The WCH group exhibited higher LVMI and PWV values, decreased E/A ratio and FMD values, and increased prevalence for left ventricular hypertrophy compared with controls (P<.001 for all). Cystatin C was significantly higher in the WCH group compared with controls (P=.035) and was positively associated with LVMI (P<.05 for both). The presence of WCH is associated with more pronounced subclinical organ damage compared with normotension. Cystatin C may play a significant role and therefore warrants further investigation.
作者研究了白大衣高血压（WCH）与亚临床器官损害及潜在相关机制之间的关系。共纳入386例未经治疗的患者，分为204例白大衣高血压患者和183例血压正常者。测量了血流介导的血管舒张功能（FMD）、脉搏波速度（PWV）、内膜中层厚度、左心室质量指数（LVMI）和胱抑素C水平。所有检验均为双侧检验，P值<0.05被认为具有统计学意义。与对照组相比，白大衣高血压组的LVMI和PWV值更高，E/A比值和FMD值降低，左心室肥厚的患病率增加（所有P值均<0.001）。与对照组相比，白大衣高血压组的胱抑素C显著更高（P = 0.035），且与LVMI呈正相关（两者P值均<0.05）。与血压正常相比，白大衣高血压的存在与更明显的亚临床器官损害相关。胱抑素C可能起重要作用，因此值得进一步研究。
