WHITE COAT HYPERTENSION AND ARTERIAL STIFFNESS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Previous studies have shown inconclusive effects of target organ damage from white-coat hypertension (WCHT). Arterial stiffness is involved in the atherosclerotic processes in the setting of sustained hypertension. This meta-analysis aimed to compare arterial stiffness in subjects with diagnosis of WCHT to subjects with normotension (NT) and SHT. Methods: A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through May 2016. The inclusion criterion was the observational studies’ assessment of the association between WCHT and NT or SHT in adult subjects. European Society of Hypertension practice guidelines for ambulatory blood pressure (BP) monitoring was used to define WCHT (office BP≥140/90mmHg and daytime BP <135/85mmHg), and SHT (office BP≥140/90mmHg and daytime BP≥135/85mmHg). Aortic stiffness was assessed using Carotid-femoral pulse wave velocity (PWV) measurements. Pooled mean difference (MD) of PWV and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Data were extracted from 4 observational studies involving 2,413 subjects. PWV is not different in patients with WCHT compared with SHT (pooled MD= -0.25 m/sec; 95% CI, -0.81 to 0.30; P-value=0.37, I 2 =74%). PWV in WCHT is also not different when compared with PWV in NT (MD= 0.86 m/sec; 95% CI, -0.30 to 2.03; P-value=0.15, I 2 =97%). Conclusion: In a meta-analysis, we observe that arterial stiffness measured by pulse wave velocity is not different in patients with white-coat hypertension when compared with sustained hypertension or normotension.

Download Full-text

Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis

Journal of Clinical Hypertension ◽

10.1111/jch.13876 ◽

2020 ◽

Vol 22 (5) ◽

pp. 802-811 ◽

Cited By ~ 3

Author(s):

Christina Antza ◽

Polychronis Vazakidis ◽

Ioannis Doundoulakis ◽

Emmanouil Bouras ◽

Anna‐Bettina Haidich ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

White Coat ◽

White Coat Hypertension ◽

Large Arteries

Download Full-text

Risk of mortality and cardiovascular events in white coat hypertension: a systematic review and meta-analysis

Journal of the American Society of Hypertension ◽

10.1016/j.jash.2016.03.130 ◽

2016 ◽

Vol 10 (4) ◽

pp. e53-e54

Author(s):

Sikarin Upala ◽

Anawin Sanguankeo

Keyword(s):

Systematic Review ◽

Cardiovascular Events ◽

Meta Analysis ◽

White Coat ◽

White Coat Hypertension ◽

Risk Of Mortality

Download Full-text

Association between homocysteine and white coat hypertension: A systematic review and meta-analysis

Journal of the American Society of Hypertension ◽

10.1016/j.jash.2016.03.122 ◽

2016 ◽

Vol 10 (4) ◽

pp. e50

Author(s):

Anawin Sanguankeo ◽

Sikarin Upala

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

White Coat ◽

White Coat Hypertension

Download Full-text

Effects of statin therapy on augmentation index as a measure of arterial stiffness: A systematic review and meta-analysis

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.03.010 ◽

2016 ◽

Vol 212 ◽

pp. 160-168 ◽

Cited By ~ 25

Author(s):

Amirhossein Sahebkar ◽

Ivan Pećin ◽

Eugenia Tedeschi-Reiner ◽

Giuseppe Derosa ◽

Pamela Maffioli ◽

...

Keyword(s):

Systematic Review ◽

Arterial Stiffness ◽

Statin Therapy ◽

Augmentation Index ◽

Meta Analysis

Download Full-text

MO501INCREASED ALBUMINURIA RISK IN CHRONIC KIDNEY DISEASE PATIENTS WHOSE WHITE COAT-, MASKED-, AND SUSTAINED HYPERTENSION: SYSTEMATIC REVIEW AND META-ANALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab087.0021 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Boby Pratama Putra ◽

Felix Nugraha Putra

Keyword(s):

Meta Analysis ◽

Blood Pressure Measurement ◽

Target Organ Damage ◽

Random Effect ◽

White Coat ◽

Cochrane Library ◽

White Coat Hypertension ◽

Masked Hypertension ◽

Sustained Hypertension ◽

Standard Mean Difference

Abstract Background and Aims Latest classification of hypertension based on ambulatory blood pressure measurement was normotension (NT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Recent studies suggest that WCHT, MHT, and SHT increase risk of target organ damage, particularly albuminuria, although the results were still inconsistent. Albuminuria is not only the sign of early glomerular damage in CKD patients, but also the signs of hypertension progression and predictors for cardiovascular events mortality. This study aims to compare the albuminuria risk among NT and WCHT, MHT, also SHT in CKD patients. Method We searched the literature comprehensively in online databases of Pubmed, EMBASE, ScienceDirect, and Cochrane Library to include all relevant studies using predefined terms until December 2020. We included studies that analyzed the albuminuria risk and compared the log2 urinary albumin-to-creatinine ratio (ACR) among NT and WCHT, MHT, or SHT in CKD patients. We used the Newcastle-Ottawa Scale for Observational Study checklist for evaluating bias risks. Analysis of the studies was conducted to provide pooled Odds Ratio (OR) for albuminuria risk and standard mean difference (SMD) for log2 ACR comparison with 95% Confidence Interval (CI) with random-effect heterogeneity test. Results We included 7 observational studies met our inclusion criteria. WCHT increases albuminuria risk although not statistically significant (pooled OR = 1.72, 95%CI 0.97 to 3.07, p = 0.06, I2 = 75%), while MHT and SHT significantly increase albuminuria risk with pooled OR respectively 1.62 (95%CI 1.03 to 2.53, p = 0.04, I2 = 82%) and 3.17 (95%CI 1.66 to 6.05, p = 0.0005, I2 = 94%). Controlled hypertension significantly protects CKD patients against albuminuria risk based on log2 ACR comparison with WCHT (SMD = 0.52, 95%CI 0.38 to 0.67, p<0.00001, I2 = 0%), MHT (SMD = 0.34, 95%CI 0.19 to 0.49, p<0.0001, I2 = 39%), and SHT (SMD = 0.63, 95%CI 0.31 to 0.95, p=0.0001, I2 = 76%). Conclusion White coat hypertension, masked hypertension, and sustained hypertension increase albuminuria risks in CKD patients. However, further studies are needed to determine the causality.

Download Full-text