Relations Between White Coat Effect of Blood Pressure and Arterial Stiffness

Objective: The aim of this study was to analyze the relationship between brachial-ankle pulse wave velocity (b-a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP, in a mixed population of normotention, untreated sustained hypertension, sustained controlled hypertension, sustained uncontrolled hypertension, white coat hypertension, white coat uncontrolled hypertension. Design and method: A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86±13.3 years) were enrolled in the study. Patients were separated into low white coat effect (< 9.5 mm Hg) and high white coat effect (>=9.5 mm Hg) according to the median of WCE. Results: The subjects with a high WCE showed a greater degree of arterial stiffness than those with a low WCE for systolic BP values (P< .05). The b-a PWV were 17.2±3.3m/s and 18.4±3.4 m/s in low WCE and high WCE, respectively. The b-a PWV increased with the increase of WCE, showing a positive correlation between them (P< .05 for non-linearity). The significant association between the high WCE and the b-a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors (beta=0.78, 95% Cl 0.25-1.31, P=. 004). Similar results were observed in subgroups. Conclusions: In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.