Key result
High white coat effect (≥9.5 mm Hg) was associated with greater arterial stiffness than low white coat effect (b-a PWV 18.4 vs 17.2 m/s; adjusted β 0.78, 95% CI 0.25-1.31, P=0.004).
Why the study?
To analyze the relationship between brachial-ankle pulse wave velocity and white coat effect across a mixed population of normotensive and hypertensive individuals.
Is a high white coat effect associated with increased arterial stiffness in patients with or without hypertension?
Observational (n=444)
Is a high white coat effect associated with increased arterial stiffness in patients with or without hypertension?
Effect estimate: β 0.78 (95% CI 0.25-1.31)
Absolute Event Rate: 18.4% vs 17.2%
p-value: p=0.004
A higher white coat effect of blood pressure is independently associated with greater arterial stiffness, suggesting it may be a marker for target organ damage.
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. 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 WCE (<9.5 mm Hg) and high WCE (≥9.5 mm Hg) according to the median of WCE. 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 ± 3.3 m/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 (β = .78, 95% Cl .25-1.31, P = . 004). Similar results were observed in subgroups. In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.
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Cao et al. (2022) conducted an observational in White coat effect of blood pressure (n=444). High white coat effect (≥9.5 mm Hg) vs. Low white coat effect (<9.5 mm Hg) was evaluated on Brachial-ankle pulse wave velocity (b-a PWV) (β 0.78, 95% CI 0.25-1.31, p=0.004). High white coat effect (≥9.5 mm Hg) was associated with greater arterial stiffness than low white coat effect (b-a PWV 18.4 vs 17.2 m/s; adjusted β 0.78, 95% CI 0.25-1.31, P=0.004).
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