P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?

DOI

10.2991/artres.k.191224.141How to use a DOI?

Abstract

Objective: International guidelines advocate conservative management of post-stroke white coat hypertension. The aims of this study were to investigate; i) does WCH/E result in increased stroke risk? and ii) is WCH/E associated with surrogate markers of cardiovascular risk?

Methods: The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of transient ischaemic attack (TIA) or lacunar stroke in the preceding 14 days. Patients were grouped by BP phenotypes. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension, n = 25 sustained hypertension). Thirty-two patients with normal BP (clinic BP <140/90 mmHg and day-time ABPM <135/85 mmHg), and 30 patients with WCH/E (clinic BP >140/90 mmHg and day-time ABPM <135/85 mmHg) were recruited. Other surrogate markers measured were; Central aortic BP (SphygoCor, AtCor Medical), QKD_100-60 interval and nocturnal dipping status (Diasys Integra II, Novocor).

Results: Compared to the normotensive cohort, patients with WCH/E were older, had a higher body mass index (BMI) and a larger proportion of patients were on anti-hypertensive medication. Both central systolic (145 ± 13 vs 118 ± 8, p < 0.001) and diastolic BP (82 ± 8 vs 76 ± 7, p = 0.004) were higher in WCH/E. The WCH/E cohort also had more lacunar strokes (p = 0.039) (Table 1).

Conclusion: In this population of post-stroke patients, WCH/E was associated with higher prevalence of lacunar stroke. These individuals also had higher central pressures despite more patients being on anti-hypertensive treatment, suggesting that post-stroke WCH/E should be managed more aggressively.

	Normotension (N = 32)	WCH/E (N = 30)	Significance
Male, n (%)	21 (66)	22 (73)	0.511
Age (years)	69.9 ± 11.5	75.7 ± 9 3	0.033
BMI (kg/m2)	25 ± 4	28 ± 4	0.014
Anti-hypertensive use, n (%)	19 (59)	23 (77)	0.146
Clinic SBP (mmHg)	125 ± 9	155 ± 13	<0.001
Clinic DBP (mmHg)	75 ± 7	81 ± 8	0.003
Daytime systolic ABPM (mmHg)	114 ± 10	121 ± 10	0.007
Daytime diastolic ABPM (mmHg)	73 ± 7	72 ± 7	0.586
Central SBP (mmHg)	118 ± 8	145 ± 13	<0.001
Central DBP (mmHg)	76 ± 7	82 ± 8	0.004
QKD100−60 interval (msec)	208 ± 18	197 ± 26	0.114
Non-dipper, n (%)	16 (57)	14 (50)	0.592
Stroke type
TIA, n (%)	25 (78)	16 (53)	0.039
Lacunar, n (%)	7 (22)	14 (47)
Data expressed as mean ± standard deviation or number (percentage). Significance determined by t-test. Chi-squared used for: anti-hypertensive use, male gender, dipping status and stroke type.

Copyright

© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

TY  - JOUR
AU  - Fran Kirkham
AU  - GN Nuredini
AU  - A Saunders
AU  - Erin Drazich
AU  - Eva Bunting
AU  - Philip Rankin
AU  - K Ali
AU  - M Okorie
AU  - Chakravarthi Rajkumar
PY  - 2020
DA  - 2020/02/17
TI  - P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?
JO  - Artery Research
SP  - S155
EP  - S155
VL  - 25
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.191224.141
DO  - 10.2991/artres.k.191224.141
ID  - Kirkham2020
ER  -