[Frequency of white coat arterial hypertension in mild hypertension. Profile of cardiovascular risk and early organic involvement].

BACKGROUND

The aim of the present was to study the frequency and characteristics of white coat hypertension (WCH) in a series of individuals with slight hypertension (SH) consecutively attended, as well as to evaluate the degree of organic involvement and the presence of other cardiovascular risk factors.

METHODS

One hundred six subjects [mean age 43 +/- 12 years, 51 males (48%)] with SH (diastolic pressure between 90-104 mmHg) who were not receiving pharmacologic treatment and did not have severe organic involvement were included in the study. Systolic/diastolic blood pressure (BP) was (x +/- SD) 150 +/- 12/96 +/- 4mmHg. The basic protocol of the Hypertension Unit was applied with out patient monitorization of BP for 24 hours with a Spacelabs 90202 monitor and a two-dimension echocardiogram with measurements according to the recommendations of the American Society of Echocardiography. WCH was defined as a mean diurnal BP (07:00-23:00 h) under 134/90 mmHg.

RESULTS

The frequency of WCH was 46%, being more frequent in those over the age of 40 years [OR: 3.08 (IC 95% 1.26-7.62) p = 0.006]. WCH was associated with total cholesterol >or= 5.2 mmol/l [OR: 2.8 (IC 95% 1.14-6.91)]. No significant associations were observed with cholesterol HDL, LDL, triglycerides, glycemia, family history of high blood pressure, body mass index and smoking. Left ventricular hypertrophy (LVH) was less frequent in WCH (6%) than in maintained hypertension (MH) (18%) (NS), while concentric remodelling was more frequent in WCH (22% and 5%, respectively [p < 0.03]). Microalbuminuria was observed in 50 individuals being >or= 30 mg/24 h in 15% of the WCH and in 30% of the MH.

CONCLUSIONS

The frequency of white coat hypertension in subjects with slight hypertension is high. The profile of cardiovascular risk among the patients with white coat hypertension and moderate hypertension is similar.