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White-coat hypertension associated with hypertrophy.

ORLANDO--White-coat hypertension is often shrugged off in clinical practice as a benign condition, but an Italian study suggests it is anything but.

Indeed, 184 young adult Italians with white-coat hypertension at baseline experienced a greater increase in 24-hour ambulatory blood pressure during 8.5 years of follow-up in the Hypertension and Ambulatory Recording Venetia Study (HARVEST) than did 286 other participants with baseline sustained hypertension, Dr. Lucio Mos reported at the annual scientific sessions of the American Heart Association.

The white-coat hypertensives were as likely to develop left ventricular hypertrophy as were subjects with sustained hypertension. Plus, HARVEST participants with white-coat hypertension gained twice as much weight during follow-up.

This evidence of problematic trends in a variety of surrogate risk markers implies an increased risk of future cardiovascular events in patients with white-coat hypertension. Tighter control of their 24-hour blood pressure along with close target organ surveillance is warranted, according to Dr. Mos of Sant' Antonio Hospital in San Daniele del Friuli, Italy.

HARVEST is a multicenter prospective Italian study that began in the 1990s. The HARVEST participants in this analysis averaged 33 years of age at enrollment and had never been treated for hypertension. During follow-up, 8.2% of the group with white-coat hypertension and 6.3% with sustained hypertension developed echocardiographic left ventricular hypertrophy.

Ambulatory blood pressure rose by an average of 7.9/5.6 mm Hg from a baseline of 120.9/76.3 mm Hg in the white-coat hypertension group, and by 1.2/1.9 mm Hg from a baseline of 135.5/83.4 mm Hg in the sustained hypertension group.

Subjects in the white-coat hypertension group gained an average of 3.5 kg, which was twice that seen in the group with sustained hypertension.

Disclosures: Dr. Mos reported having no financial conflicts of interest in connection with the government-funded study.

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Author:Jancin, Bruce
Publication:Internal Medicine News
Article Type:Brief article
Geographic Code:1USA
Date:Mar 15, 2010
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