Key result
White-coat hypertension is linked to higher aortic valve peak velocity versus other phenotypes.
Why the study?
Hypertension phenotypes are challenging to distinguish during a single office visit, and aortic valve peak velocity—an echocardiographic parameter associated with sympathetic nervous system hyperactivity—could potentially help differentiate them.
Is aortic valve peak velocity measured by echocardiography associated with specific hypertension phenotypes, particularly white-coat hypertension, in patients evaluated at a hypertension unit?
Cross-Sectional (n=384)
No
Is aortic valve peak velocity measured by echocardiography associated with specific hypertension phenotypes, particularly white-coat hypertension, in patients evaluated at a hypertension unit?
Elevated aortic valve peak velocity on echocardiography is associated with white-coat hypertension and shows moderate diagnostic accuracy as a supportive tool to help identify this phenotype in patients with elevated office blood pressure.
Answers are grounded in this paper and cite their sources.
May support echocardiography for white-coat hypertension phenotyping; leaves open prospective validation before clinical adoption.
Background/Introduction Hypertension phenotypes reflect the agreement or disagreement between office and out-of-office blood pressure (BP) measurements and are challenging to distinguish during a single office visit. Increased sympathetic nervous system (SNS) activity is implicated in their pathophysiology. Aortic valve peak velocity, an echocardiographic parameter associated with SNS hyperactivity and high cardiac output states, may help differentiate hypertension phenotypes. Purpose This study examined the association between hypertension phenotypes and aortic valve peak velocity. Methods Cross-sectional analysis of consecutive patients evaluated at a reference Hypertension Unit who underwent office (OBP), ambulatory BP (ABP) monitoring, and echocardiography. Results A total of 384 participants were included (mean age 58 years; 55% male; 60% treated systolic/diastolic OBP 136/84 mmHg, ABP 126/77 mmHg, aortic valve peak velocity 1.31 m/s, 34% normotension/controlled hypertension, 18% white-coat hypertension/white-coat uncontrolled hypertension (WCH/WCUH), 16% masked hypertension/masked uncontrolled hypertension, 32% sustained hypertension/uncontrolled hypertension]. Aortic valve peak velocity was significantly higher in the WCH/WCUH group (1.40±0.26 m/s) compared with all other phenotypes (P < 0.01) (Figure). This finding was consistent in analyses restricted to untreated patients and to those with a short ABP-echocardiography time interval, and remained significant in multivariable linear regression models. Among participants with office hypertension, a cut-off value of 1.32 m/s demonstrated moderate diagnostic accuracy for identifying WCH/WCUH (sensitivity 62%, specificity 66%). Conclusion(s) Aortic valve peak velocity is significantly elevated in WCH/WCUH and may serve as a supportive clinical tool to help identify or exclude this phenotype in patients presenting with office hypertension, particularly in untreated individuals undergoing baseline echocardiography.
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Kyriakoulis et al. (2026) conducted a cross-sectional in Hypertension phenotypes (including white-coat hypertension/white-coat uncontrolled hypertension) (n=384). White-coat hypertension / white-coat uncontrolled hypertension (WCH/WCUH) vs. Other hypertension phenotypes (normotension/controlled, masked/masked uncontrolled, sustained/uncontrolled) was evaluated on Aortic valve peak velocity (m/s) (p=< 0.01). White-coat hypertension/uncontrolled hypertension was associated with significantly higher aortic valve peak velocity (1.40±0.26 m/s) compared with all other phenotypes (P<0.01).
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