Artery Research

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Volume 25, Issue Supplement 1, December 2019, Pages S156 - S156

P116 Post-stroke White Coat Hypertension/Effect is Associated with Greater Arterial Stiffness

Authors
Fran Kirkham1, *, A Saunders2, GN Nuredini2, E Drazich3, Philip Rankin3, E Bunting3, K Ali2, 3, M Okorie2, 3, C Rajkumar2, 3
1Brighton and Sussex University College Hospitals Trust, UK
2Department of Medicine, Brighton and Sussex Medical School, Brighton, UK
3Department of Elderly Care and Stroke Medicine, Brighton and Sussex University Hospitals Trust, Brighton, UK
*Corresponding author. Email: cooldudettefran@hotmail.com
Corresponding Author
Fran Kirkham
Available Online 17 February 2020.
DOI
10.2991/artres.k.191224.142How to use a DOI?
Abstract

Objective: White coat hypertension/effect (WCH/E) describes an elevated clinic blood pressure (BP) with normal daytime ambulatory BP (ABPM) values. It is not clear whether WCH/E is associated with adverse vascular risk. This study aimed to determine the relationship between WCH/E and arterial stiffness in a cohort of patients who had a transient ischaemic attack (TIA) or lacunar stroke (LS).

Design and Method: The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of TIA or LS in the preceding 14 days. Patients were grouped by BP. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension and 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. Arterial stiffness was measured using carotid-femoral pulse wave velocity (PWV), (Complior®, ALAM Medical) and carotid-ankle vascular index (CAVI), (VaSera VS-1500 N®, Fukuda Denshi).

Results: Compared to patients with normal BP, patients with WCH/E were older, had a higher body mass index (BMI) and higher arterial stiffness measured by CAVI (10.3 ± 1.3 vs 9.4 ± 1.7, p = 0.027), and PWV (11.9 ± 3.0 vs 9.6 ± 2.3 ms−1, p = 0.002). The WCH/E cohort had more lacunar strokes (p = 0.039).

Conclusion: In this population of post-stroke patients, those with WCH/E had greater arterial stiffness and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.

Normotension (N = 32) WCH/E (N = 30) Statistical 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 systolic BP (mmHg) 125 ± 9 155 ± 13 <0.001
Clinic diastolic BP (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
CAVI 9.4 ± 1.7 10.3 ± 1.3 0.027
PWV (ms−1) 9.6 ± 2.3 11.9 ± 3.0 0.002
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, gender 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/).

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<Previous Article In Issue
Next Article In Issue>
Journal
Artery Research
Volume-Issue
25 - Supplement 1
Pages
S156 - S156
Publication Date
2020/02/17
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.2991/artres.k.191224.142How to use a DOI?
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/).

Cite this article

risenwbib
TY  - JOUR
AU  - Fran Kirkham
AU  - A Saunders
AU  - GN Nuredini
AU  - E Drazich
AU  - Philip Rankin
AU  - E Bunting
AU  - K Ali
AU  - M Okorie
AU  - C Rajkumar
PY  - 2020
DA  - 2020/02/17
TI  - P116 Post-stroke White Coat Hypertension/Effect is Associated with Greater Arterial Stiffness
JO  - Artery Research
SP  - S156
EP  - S156
VL  - 25
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.191224.142
DO  - 10.2991/artres.k.191224.142
ID  - Kirkham2020
ER  -