Functional and Structural Heart Conditions Associated With White-Coat Hypertension in Comparison With True Hypertension and Normal Blood Pressure States

This study attempted to evaluate functional and structural cardiac states using echocardiography in patients with white-coat hypertension in comparison with true hypertension and normotensive conditions.
The study population consisted of 72 individuals, aged 25 to 75 years. The subjects were assigned to 4 groups: white-coat hypertensives (n=20), controlled true hypertensives (n=20), uncontrolled true hypertensives (n=12), and a normotensive group (n=20). Whilst the 4 sub- groups in the study exhibited a similar gender distribution, the normotensive subjects were significantly younger; however, there was no discrepancy in the mean age between the white- coat hypertensive group and the other hypertensive subgroups. Univariate comparisons between the functional and structural cardiac parameters of the white-coat hypertensives and the other study groups revealed low deceleration time and E’-wave velocity and high E-wave velocity and left ventricular internal dimension indices compared with the other 2 hypertensive groups.
After adjustment for sex and age, the white-coat hypertensive group revealed differing results in 2 indices of E’ wave velocity and interventricular septal thickness (IVST) when compared with the other three. A number of features were identified as the hallmarks of white-coat hypertensives: specific functional and structural cardiac changes such as low IVST in comparison with the uncontrolled hypertensives; presence of diastolic dysfunction, which was not found in the normotensives; and greater cardiac mass than that in the normotensives, less than that in the uncontrolled hypertensives, but closer to that in the controlled hypertensives.
Although the prognosis for patients with white-coat hypertension is not as grave as that for those with true hypertension, it is considerably worse than the prognosis among the normal population.