P3.04 AORTIC STIFFNESS IS INDEPENDENTLY ASSOCIATED WITH WHITE COAT EFFECT

DOI

10.1016/j.artres.2009.10.033How to use a DOI?

Abstract

Introduction: The difference between systolic blood pressure (SBP) measured in clinic and during the daytime phase of ambulatory BP measurement (ABPM) (Δclinic-day ABPM SBP) has been used as a measure of white-coat effect. We hypothesised that this was mediated through increased aortic stiffness resulting in greater increase in SBP from increased sympathetic activity in response to a hospital visit.

Methods: Patients enrolled in the Anglo-Cardiff Collaborative Trial between 2000–2009 underwent measurement of aortic stiffness by carotid-femoral pulse wave velocity (C-F PWV, Sphygmocor) and 24h ABPM (Spacelabs-90207). Δclinic-day ABPM SBP was calculated. C-F PWV was adjusted for mean BP, and it was log-transformed for analysis due to non-parametric distribution.

Results: The total study population was 477 subjects, mean age 45±20 years, 44.9% male, 1.6% diabetic and 33.3% current or ex-smokers. Mean clinic BP was 146±18/88±12 and mean 24h day ABPM was 137±13/83±1.1 _LogC-F PWV correlated with Δ clinic-day ABPM SBP (rho=0.13, P<0.01) and there was a significant trend for increased _logC-F PWV with increased tertiles of increased Δclinic-day ABPM SBP (P<0.01). In stepwise multivariate analysis, independent determinants of Δclinic-day ABPM SBP were _logC-F PWV, heart rate and age (total R²=0.11, P<0.001) while diabetes, gender, smoking and BMI were excluded.

Conclusion: Aortic stiffness is independently associated with the degree of rise of SBP between home and clinic in a population with a broad age range and low co-morbidity. This may have important implications for using clinic values of BP to guide antihypertensive treatment in patients with high aortic stiffness.

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TY  - JOUR
AU  - C.A. Taylor
AU  - L.A. Tomlinson
AU  - C.M. McEniery
AU  - I.B. Wilkinson
PY  - 2009
DA  - 2009/12/03
TI  - P3.04 AORTIC STIFFNESS IS INDEPENDENTLY ASSOCIATED WITH WHITE COAT EFFECT
JO  - Artery Research
SP  - 181
EP  - 181
VL  - 3
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2009.10.033
DO  - 10.1016/j.artres.2009.10.033
ID  - Taylor2009
ER  -