國家衛生研究院 NHRI:Item 3990099045/7329
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/7329


    Title: White coat hypertension is more risky than prehypertension: Important role of arterial wave reflections
    Other Titles: White coat hypertension is more risky than prehypertension Important role of arterial wave reflections
    Authors: Sung, SH;Cheng, HM;Wang, KL;Yu, WC;Chuang, SY;Ting, CT;Lakatta, EG;Yin, FCP;Chou, P;Chen, CH
    Contributors: Division of Health Services and Preventive Medicine
    Abstract: Arterial aging may link cardiovascular risk to white coat hypertension (WCH). The aims of the present study were to investigate the role of arterial aging in the white coat effect, defined as the difference between office and 24-hour ambulatory systolic blood pressures, and to compare WCH with prehypertension (PH) with respect to target organ damage and long-term cardiovascular mortality. A total of 1257 never-been-treated volunteer subjects from a community-based survey were studied. WCH and PH were defined by office and 24-hour ambulatory blood pressures. Left ventricular mass index, carotid intima-media thickness, estimated glomerular filtration rate, carotid-femoral pulse wave velocity, carotid augmentation index, amplitude of the reflection pressure wave, and 15-year cardiovascular mortality were determined. Subjects with WCH were significantly older and had greater body mass index, blood pressure values, intima-media thickness, carotid-femoral pulse wave velocity, augmentation index, amplitude of the backward pressure wave, and a lower estimated glomerular filtration rate than PH. Amplitude of the backward pressure wave was the most important independent correlate of the white coat effect in multivariate analysis (model r=0.451; partial r/model r=90.5%). WCH had significantly greater cardiovascular mortality than PH (hazard ratio, 2.94; 95% confidence interval, 1.09-7.91), after accounting for age, sex, body mass index, smoking, fasting plasma glucose, and total cholesterol/high-density lipoprotein-cholesterol ratio. Further adjustment of the model for amplitude of the backward pressure wave eliminated the statistical significance of the WCH effect. In conclusion, the white coat effect is mainly caused by arterial aging. WCH carries higher risk for cardiovascular mortality than PH, probably via enhanced wave reflections that accompany arterial aging.
    Date: 2013-07
    Relation: Hypertension. 2013 Jul;61(6):1346-1353.
    Link to: http://dx.doi.org/10.1161/HYPERTENSIONAHA.111.00569
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0194-911X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000319162800039
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84878903054
    Appears in Collections:[Shao-Yuan Chuang] Periodical Articles

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