Cai Peng, Peng Yan, Wang Yan, Wang Xukai
Department of Cardiology, Institute of Field Surgery, Daping Hospital, Third Military Medical University, Chongqing.
Key Laboratory of Basic Pharmacology of Ministry of Education Joint International Research Laboratory of Ministry Education, Zunyi Medical University, Zunyi, China.
Medicine (Baltimore). 2018 Oct;97(42):e12888. doi: 10.1097/MD.0000000000012888.
White-coat hypertension (WCH) is a debatable risk factor of cardio-cerebrovascular diseases and the current study results on the association between WCH and arterial stiffness are inconsistent. The aim was to investigate the effect of WCH on arterial stiffness using meta-analysis.
Based on prespecified search strategies and inclusion criteria, Medline, Embase, Web Of Science, Cochrane Library, and BioSciences Information Service Preview databases were reviewed. A total of 20 studies involving 1538 WCH patients and 3582 normotensives (NT) were included. Literatures were screened for data extraction and quality assessment. Overall analysis and subgroup analysis were conducted in RevMan version 5.3 and Stata version 14.0 software.
Overall analysis showed that carotid-femoral pulse wave velocity (cf-PWV) was significantly higher in WCH group than in the NT group (P < .00001, 95% CI: 0.79-3.26). Subgroup analysis showed that in adults, cf-PWV was significantly higher in the WCH patients than in the NT subjects (P<.001, 95% CI: 0.46-0.87), while in juveniles, cf-PWV was comparable between the WCH group and the NT group (P = .25, 95% CI: -0.39 to 0.61).
This meta-analysis showed that WCH may increase arterial stiffness in adult population.
白大衣高血压（WCH）是一种存在争议的心脑血管疾病危险因素，目前关于WCH与动脉僵硬度之间关联的研究结果并不一致。本研究旨在通过荟萃分析探讨WCH对动脉僵硬度的影响。
基于预先设定的检索策略和纳入标准，对Medline、Embase、科学网、Cochrane图书馆和生物科学信息服务预览数据库进行了检索。共纳入20项研究，涉及1538例WCH患者和3582例血压正常者（NT）。对文献进行筛选以提取数据并进行质量评估。在RevMan 5.3版和Stata 14.0版软件中进行总体分析和亚组分析。
总体分析显示，WCH组的颈股脉搏波速度（cf-PWV）显著高于NT组（P<0.00001，95%CI：0.79 - 3.26）。亚组分析显示，在成年人中，WCH患者的cf-PWV显著高于NT受试者（P<0.001，95%CI：0.46 - 0.87），而在青少年中，WCH组和NT组的cf-PWV相当（P = 0.25，95%CI：-0.39至0.61）。
这项荟萃分析表明，WCH可能会增加成年人群的动脉僵硬度。
