Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, IR Iran
Department of Cardiology, Najafabad Branch , Islamic Azad University, Najafabad Isfahan, IR Iran
Candidate, Departments of Metabolic Syndrome, Isfahan Cardiovascular Research Center, Isfahan University of Medicine Sciences, Isfahan, IR Iran
Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan , IR Iran
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