Manios Efstathios, Michas Fotios, Stamatelopoulos Kimon, Koroboki Eleni, Lykka Aikaterini, Vettou Charitini, Vemmos Konstantinos, Zakopoulos Nikolaos
Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece.
J Clin Hypertens (Greenwich). 2016 Nov;18(11):1095-1102. doi: 10.1111/jch.12888. Epub 2016 Aug 2.
The clinical importance of white-coat hypertension (WCH) remains a controversial issue. The aim of this study was to evaluate the association of isolated systolic, isolated diastolic, and systolic/diastolic WCH with common carotid artery intima-media thickness (CCA-IMT) and to compare each subgroup of WCH against other blood pressure (BP) phenotypes in terms of CCA-IMT values. A total of 1382 consecutive patients underwent 24-hour ambulatory BP monitoring and carotid artery ultrasonographic measurements. According to the type of elevated office BP, WCH was divided into three groups: isolated systolic, isolated diastolic, and systolic/diastolic WCH. Patients with isolated systolic WCH (n=112) had significantly higher CCA-IMT values (0.737 mm) than those with isolated diastolic WCH (n=66) (0.685 mm) and nonsignificantly greater compared with those with systolic/diastolic WCH (n=228) (0.708 mm). Patients with isolated systolic WCH had CCA-IMT values similar to those with hypertension, patients with isolated diastolic WCH had similar values to those with normotension, and patients with systolic/diastolic WCH had an intermediate risk between normotension and hypertension.
白大衣高血压（WCH）的临床重要性仍然是一个有争议的问题。本研究的目的是评估单纯收缩期、单纯舒张期和收缩期/舒张期WCH与颈总动脉内膜中层厚度（CCA-IMT）之间的关联，并根据CCA-IMT值比较WCH的每个亚组与其他血压（BP）表型。共有1382例连续患者接受了24小时动态血压监测和颈动脉超声测量。根据诊室血压升高的类型，WCH分为三组：单纯收缩期、单纯舒张期和收缩期/舒张期WCH。单纯收缩期WCH患者（n = 112）的CCA-IMT值（0.737 mm）显著高于单纯舒张期WCH患者（n = 66）（0.685 mm），与收缩期/舒张期WCH患者（n = 228）（0.708 mm）相比无显著差异。单纯收缩期WCH患者的CCA-IMT值与高血压患者相似，单纯舒张期WCH患者的值与血压正常者相似，收缩期/舒张期WCH患者的风险介于血压正常和高血压之间。
