Attenuation of the “White-Coat Effect” by Antihypertensive Treatment and Regression of Target Organ Damage
Key result
Long-term ACE inhibitor treatment reduced clinic-daytime and clinic-home BP differences by up to 77.1% (P<0.01), but these reductions had no significant relationship with left ventricular mass index regression.
Why the study?
Does the attenuation of the white-coat effect by antihypertensive treatment predict the regression of left ventricular hypertrophy in patients with essential hypertension?
Population
206 patients with essential hypertension who had a diastolic BP between 95 and 115 mm Hg and…
Comparison
Angiotensin-converting enzyme inhibitor for 12… vs Baseline measurements (within-subject comparison).
Design
Cohort
Follow-up
12 months plus 4-week run-off
Authors
Discussion
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Implication
ACE inhibitor attenuation of white-coat effect was unrelated to LVMI regression; leaves open whether clinic-home BP differences predict cardiac remodeling.
Study Design
Type
Cohort (n=206)
Structured PICO
Does the attenuation of the white-coat effect by antihypertensive treatment predict the regression of left ventricular hypertrophy in patients with essential hypertension?
P
Population
206 patients with essential hypertension (aged 20 to 65 years) who had a diastolic BP between 95 and 115 mm Hg and echocardiographic evidence of left ventricular hypertrophy.
I
Intervention
Angiotensin-converting enzyme inhibitor for 12 months, followed by a 4-week placebo run-off period.
C
Comparator
Baseline measurements (within-subject comparison).
O
Outcome
Attenuation of clinic-daytime and clinic-home differences in blood pressure and its relationship to treatment-induced regression of left ventricular mass index after 12 months of treatment.surrogate
Reductions in the white-coat effect (clinic-daytime or clinic-home BP differences) during antihypertensive treatment do not predict the regression of left ventricular hypertrophy.
Cite This Study
Parati et al. (2000) conducted a cohort in Essential hypertension (n=206). Angiotensin-converting enzyme inhibitor vs. Baseline was evaluated on Relationship between treatment-induced reductions in left ventricular mass index and clinic-daytime or clinic-home differences for systolic and diastolic BP. Long-term ACE inhibitor treatment reduced clinic-daytime and clinic-home BP differences by up to 77.1% (P<0.01), but these reductions had no significant relationship with left ventricular mass index regression.