Barochiner Jessica, Aparicio Lucas S, Alfie José, Morales Margarita S, Cuffaro Paula E, Rada Marcelo A, Marin Marcos J, Galarza Carlos R, Waisman Gabriel D
Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
J Clin Hypertens (Greenwich). 2017 Jan;19(1):6-10. doi: 10.1111/jch.12913. Epub 2016 Sep 28.
Arterial stiffness, assessed through pulse wave velocity (PWV), independently predicts cardiovascular outcomes. In untreated persons, white-coat hypertension (WCH) has been related to arterial stiffness, but data in treated patients with WCH are scarce. The authors aimed to determine a possible association between WCH and arterial stiffness in this population. Adult treated hypertensive patients underwent home blood pressure monitoring and PWV assessment. Variables associated with PWV in univariable analyses were entered into a multivariable linear regression model. The study included 121 patients, 33.9% men, median age 67.9 (interquartile range 18.4) years, 5.8% with diabetes, and 3.3% with a history of cardiovascular or cerebrovascular disease. In multivariable analysis, WCH in treated hypertensive patients remained a determinant of PWV: β=1.1 (95% confidence interval, 0.1-2.1 [P=.037]; adjusted R 0.49). In conclusion, WCH is independently associated with arterial stiffness in treated hypertensive patients. Whether this high-risk association is offset by antihypertensive treatment should be further investigated.
通过脉搏波速度（PWV）评估的动脉僵硬度可独立预测心血管疾病转归。在未经治疗的人群中，白大衣高血压（WCH）与动脉僵硬度有关，但关于接受治疗的WCH患者的数据较少。作者旨在确定该人群中WCH与动脉僵硬度之间可能存在的关联。成年接受治疗的高血压患者接受了家庭血压监测和PWV评估。单变量分析中与PWV相关的变量被纳入多变量线性回归模型。该研究纳入了121例患者，男性占33.9%，中位年龄67.9（四分位间距18.4）岁，5.8%患有糖尿病，3.3%有心血管或脑血管疾病史。在多变量分析中，接受治疗的高血压患者中的WCH仍然是PWV的一个决定因素：β=1.1（95%置信区间，0.1 - 2.1 [P = 0.037]；调整后R² 0.49）。总之，在接受治疗的高血压患者中，WCH与动脉僵硬度独立相关。这种高风险关联是否会被降压治疗抵消应进一步研究。
