Τίτλος:
Similar levels of low-grade inflammation and arterial stiffness in masked and white-coat hypertension: Comparisons with sustained hypertension and normotension
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Andrikou, I.
Tsioufis, C.
Dimitriadis, K.
Syrseloudis, D.
Valenti, P.
Almiroudi, M.
Lioni, L.
Tousoulis, D.
Stefanadis, C.
Περιοδικό:
Blood Pressure Monitoring
Λέξεις-κλειδιά:
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
DOI:
10.1097/MBP.0b013e32834af710
