TY - JOUR
TI - Similar levels of low-grade inflammation and arterial stiffness in masked and white-coat hypertension: Comparisons with sustained hypertension and normotension
AU - Andrikou, I.
AU - Tsioufis, C.
AU - Dimitriadis, K.
AU - Syrseloudis, D.
AU - Valenti, P.
AU - Almiroudi, M.
AU - Lioni, L.
AU - Tousoulis, D.
AU - Stefanadis, C.
JO - Blood Pressure Monitoring
PY - 2011
VL - 16
TODO - 5
SP - 218-223
PB - 
SN - 1359-5237, 1473-5725
TODO - 10.1097/MBP.0b013e32834af710
TODO - C reactive protein, adult;  arterial stiffness;  article;  blood pressure;  comparative study;  controlled study;  disease course;  female;  hemodynamics;  human;  hypertension;  inflammation;  major clinical study;  male;  masked hypertension;  priority journal;  prognosis;  pulse wave;  sustained hypertension;  systolic blood pressure;  vascular disease;  white coat hypertension, Adult;  Blood Flow Velocity;  Blood Pressure;  Blood Pressure Monitoring, Ambulatory;  C-Reactive Protein;  Cross-Sectional Studies;  Echocardiography;  Female;  Humans;  Hypertension;  Inflammation;  Male;  Masked Hypertension;  Middle Aged;  Prognosis;  Pulsatile Flow;  Vascular Stiffness;  White Coat Hypertension
TODO - Objective: The clinical significance of masked hypertension (MHT) and white-coat hypertension (WCHT) remains controversial, whereas subclinical inflammation and arterial stiffness are associated with an adverse prognosis. We examined the interrelationships of MHT, WCHT, and sustained hypertension (SHT) with high-sensitivity C-reactive protein (hs-CRP) and arterial stiffness. Methods: Our population consisted of 291 untreated nondiabetic patients with MHT [office blood pressure (BP) <140/90 mmHg and daytime BP ≥ 135/85 mmHg; n=32], WCHT (office BP ≥ 140/90 mmHg and daytime BP <135/85 mmHg; n=81), SHT (office BP ≥ 140/90 mmHg and daytime BP ≥ 135/85 mmHg; n=178), and 44 age-matched and sex-matched control normotensives. Results: SHT compared with WCHT, MHT, and normotension exhibited higher pulse wave velocity (PWV; 8.2±1.4 vs. 7.5±1.2 vs. 7.3±0.9 vs. 6.8±0.5 m/s, respectively; P<0.05) and hs-CRP (2.8±0.7 vs. 2.2±0.6 vs. 1.9±0.4 vs. 1.2±0.3 mg/l, respectively; P<0.05), independently of confounders. Of note, there was no difference between the MHT and WCHT groups with regard to hs-CRP and PWV levels (P=not significant). In hypertensives, hs-CRP was associated with 24-h systolic BP (r=0.350, P<0.0001) and PWV (r=0.228, P<0.0001), whereas PWV was associated with 24-h systolic BP (r=0.330, P<0.0001). Conclusion: MHT and WCHT represent two states of equivalent subclinical vascular dysfunction reflected by hs-CRP and PWV. Moreover, MHT and WCHT are characterized by a higher degree of inflammatory activation and arterial stiffening compared with normotension and by a lesser degree compared with SHT. The association of 24-h BP with both hs-CRP and PWV underscores the dominant role of hemodynamic load on hypertensive damage progression. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
ER -