The white-coat effect was inversely correlated with daytime ambulatory systolic (r = -0.22, P<0.000) and diastolic (r = -0.50, P<0.000) blood pressure, with no association to left ventricular mass.
Cross-Sectional (n=1,581)
How does the white-coat effect vary with daytime ambulatory blood pressure levels, and is it associated with left ventricular mass?
The white-coat effect is inversely associated with daytime ambulatory blood pressure levels and does not correlate with left ventricular mass, suggesting it may not independently drive target organ damage.
Effect estimate: r = -0.22 (systolic), r = -0.50 (diastolic)
p-value: p=< 0.000
OBJECTIVES: The difference between clinic and daytime ambulatory blood pressure is referred to as the white-coat effect. In this study, we investigated (i) the magnitude of the white-coat effect in subjects with different daytime ambulatory blood pressure levels, and (ii) the association of the white-coat effect with left ventricular mass. METHODS: A total of 1581 subjects underwent clinic blood pressure readings, 24-h ambulatory blood pressure monitoring and left ventricular echocardiographic assessment. Their mean daytime systolic blood pressure varied from 88.0 to 208.9 mmHg and their mean daytime diastolic blood pressure from 40.3 to 133.0 mmHg. RESULTS: A negative correlation was found between the systolic or diastolic white-coat effect and the systolic or diastolic daytime ambulatory blood pressure (r = -0.22, P < 0.000 and r = -0.50, P < 0.000, respectively). Left ventricular mass significantly correlated with ambulatory blood pressure (P < 0.001), but there was no association between left ventricular mass and clinic blood pressure or white-coat effect. Furthermore, the white-coat effect was reversed at the highest level of systolic or diastolic daytime ambulatory blood pressure (systolic over 170 mmHg or diastolic over 100 mmHg) when systolic or diastolic daytime ambulatory blood pressure was higher than systolic or diastolic clinic blood pressure (ambulatory blood pressure hypertension). CONCLUSIONS: The white-coat effect shows an inverse association with daytime ambulatory blood pressure level (systolic or diastolic), being significantly more prominent for levels below 140/80 mmHg for systolic/diastolic daytime ambulatory blood pressure and reversed with daytime ambulatory blood pressure levels above 170/100 mmHg.
Zakopoulos et al. (Tue,) conducted a cross-sectional in Normotension and hypertension (n=1,581). Daytime ambulatory blood pressure was evaluated on Correlation between white-coat effect and daytime ambulatory blood pressure (r = -0.22 (systolic), r = -0.50 (diastolic), p=< 0.000). The white-coat effect was inversely correlated with daytime ambulatory systolic (r = -0.22, P<0.000) and diastolic (r = -0.50, P<0.000) blood pressure, with no association to left ventricular mass.