TARGET ORGAN STATUS AND SERUM-LIPIDS IN PATIENTS WITH WHITE COAT HYPERTENSION

Target organ status and serum lipids were investigated in white coat hypertension in comparison with sustained hypertension and normotension. We selected three groups balanced for sex, age, body mass index, and smoking habit: 50 sustained hypertensives (clinical hypertension and 24-hour ambulatory blood pressure >135/85 mm Hg, a cutoff limit obtained from a normotensive population), 25 white coat hypertensives (clinical hypertension and 24-hour ambulatory blood pressure <135/85 mm Hg), and 25 normotensives. Subjects underwent echocardiographic examination to assess left ventricular mass index, carotid ultrasonography to evaluate intima-media thickness and atherosclerotic plaques, venous occlusion plethysmography to record minimum forearm vascular resistance, and determinations of serum lipid profile and 24-hour urinary albumin excretion. Compared with sustained hypertensives, the white coat hypertensives had significantly lower values of left ventricular mass index (125.9+/-20 versus 97.6+/-11.5 g/m(2), P<.05), intima-media thickness (0.85+/-0.18 versus 0.71+/-0.15 mm, P<.05), minimum forearm vascular resistance (2.33+/-0.11 versus 2.04+/-0.08 resistance units, P<.05), urinary albumin excretion values (15.1+/-13.8 versus 4.45+/-1.45 mg per 24 hours, P<.0001), prevalence of left ventricular hypertrophy (38% versus 4%, P<.002), intima-media thickening (28% versus 4%, P<.015), and microalbuminuria (22% versus 0%, P<.015). No significant difference, however, was observed between the white coat hypertensives and the normotensives. Serum lipid profile was similar in the white coat hypertensives and in the normotensives. In conclusion, our data demonstrate that white coat hypertensives do not show target organ damage and do not present an unfavorable lipid profile, suggesting that they may be counseled on nonpharmacological therapy and that drug treatment could be withheld or delayed.