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

Background: This study attempted to evaluate functional and structural cardiac states usingechocardiography in patients with white-coat hypertension in comparison with truehypertension and normotensive conditions.Methods: The study population consisted of 72 individuals, aged 25 to 75 years. The subjects wereassigned 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 subgroups in the study exhibited a similar gender distribution, the normotensive subjects weresignificantly younger; however, there was no discrepancy in the mean age between the whitecoat hypertensive group and the other hypertensive subgroups. Univariate comparisons betweenthe functional and structural cardiac parameters of the white-coat hypertensives and the otherstudy groups revealed low deceleration time and E’-wave velocity and high E-wave velocityand left ventricular internal dimension indices compared with the other 2 hypertensive groups.Results: After adjustment for sex and age, the white-coat hypertensive group revealed differing resultsin 2 indices of E’ wave velocity and interventricular septal thickness (IVST) when comparedwith the other three. A number of features were identified as the hallmarks of white-coathypertensives: specific functional and structural cardiac changes such as low IVST incomparison with the uncontrolled hypertensives; presence of diastolic dysfunction, which wasnot found in the normotensives; and greater cardiac mass than that in the normotensives, lessthan that in the uncontrolled hypertensives, but closer to that in the controlled hypertensives.Conclusions: Although the prognosis for patients with white-coat hypertension is not as grave as thatfor those with true hypertension, it is considerably worse than the prognosis among the normalpopulation.