Functional and Structural Heart Conditions Associated With White-Coat Hypertension in Comparison With True Hypertension and Normal Blood Pressure States


1 Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, IR Iran

2 Department of Cardiology, Najafabad Branch , Islamic Azad University, Najafabad Isfahan, IR Iran

3 Candidate, Departments of Metabolic Syndrome, Isfahan Cardiovascular Research Center, Isfahan University of Medicine Sciences, Isfahan, IR Iran

4 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan , IR Iran

5 Isfahan Cardiovascular Research center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran.


Background: This study attempted to evaluate functional and structural cardiac states using
echocardiography in patients with white-coat hypertension in comparison with true
hypertension and normotensive conditions.
Methods: The study population consisted of 72 individuals, aged 25 to 75 years. The subjects were
assigned to 4 groups: white-coat hypertensives (n=20), controlled true hypertensives (n=20),
uncontrolled true hypertensives (n=12), and a normotensive group (n=20). Whilst the 4 subgroups in the study exhibited a similar gender distribution, the normotensive subjects were
significantly younger; however, there was no discrepancy in the mean age between the whitecoat hypertensive group and the other hypertensive subgroups. Univariate comparisons between
the functional and structural cardiac parameters of the white-coat hypertensives and the other
study groups revealed low deceleration time and E’-wave velocity and high E-wave velocity
and left ventricular internal dimension indices compared with the other 2 hypertensive groups.
Results: After adjustment for sex and age, the white-coat hypertensive group revealed differing results
in 2 indices of E’ wave velocity and interventricular septal thickness (IVST) when compared
with the other three. A number of features were identified as the hallmarks of white-coat
hypertensives: specific functional and structural cardiac changes such as low IVST in
comparison with the uncontrolled hypertensives; presence of diastolic dysfunction, which was
not found in the normotensives; and greater cardiac mass than that in the normotensives, less
than that in the uncontrolled hypertensives, but closer to that in the controlled hypertensives.
Conclusions: Although the prognosis for patients with white-coat hypertension is not as grave as that
for those with true hypertension, it is considerably worse than the prognosis among the normal