[LB.01.06] LONG-TERM RISK OF CARDIOVASCULAR EVENTS IN WHITE-COAT HYPERTENSION DEFINED BY DAYTIME AND NIGHTTIME BLOOD PRESSURE LIMITS. (September 2017)

• Record Type: Journal Article
• Authors: Faria, J.; Bertoquini, S.; Silva, J.; Barbosa, L.; Polonia, J.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523039.73654.c7
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The prognostic impact of white-coat hypertension (WCHT) is a subject of debate and controversy. Nighttime blood pressure (BP) is strongly related with cardiovascular (CV) prognosis but thiat has not been currently considered in the definition of WCHT. Figure. No caption available. Design and method: We investigated the occurrence of fatal and non-fatal CV events in 1230 subjects with sustained hypertension (SHTA), 617 with WCHT and 812 with normotension (NT) during a mean of follow-up 93 months (95% CI 90–96), all matched for age (by clusters) - mean age 50 yrs (95% CI 49–51). Percentage of female in the 3 groups were (55–59%). WCHT was defined as hypertension in office and daytime BP <135/85 mm Hg and nighttime BP <120/70 mm Hg. Results: During the follow-up 257 CV events were detected (46% strokes, 32% coronary and 22% others). The event rate per 100 patient-years in the subjects with NT, WCHT and SHTA was 0.66, 0.60 and 2.09 respectively. Event-free survival was significantly (p < 0.0001) different among the three groups (see Figure 1). Cox regression analysis with adjustment for covariables were able to show that risk of CV events was significantly (p < 0.001) higher with a Relative Risk of 4.12 (CI 95% 2.99–6.69) in subjects with SHTA than in those with WCHT whereas there was no difference between subjects with WCHT and with NT. Within the group of WCHT 29% received therapy during the follow-up for at least six months but the RR of CV events betweenWCHT either treated or non-treated did not differ: RR = 0.76 (CI95% 0.37–1.51, p = 0.42). Conclusions: In subjects with WCHT with normal daytime and nighttime BP the risk of CV events was significantly lower than that in SHTA and not significantly different from normotensive subjects. Also anti-hypertensive treatment seems not to modify the low risk of CV events in WCHT.