P3.19 ASSESSMENT OF CARDIOVASCULAR RISK IN HYPERTENSIVES WITH WHITE COAT EFFECT VS. PATIENTS WITH MASKED UNCONTROLLED HYPERTENSION

Abstract

Background: According to current ESH guidelines cardiovascular risk assessment is recommended in vast majority of patients with hypertension. However the groups of patients exist where risk assessment may be challenging. Aim: The aim of our analysis was to compare risk factors, and target organ damage profiles in two groups of hypertensive patients with discrepant results in office vs. ambulatory blood pressure values. Methods: From the outpatient hypertensive cohort (N=773) two groups were chosen – (1) white coat effect patients “WCHT” with systolic office blood pressure (OSBP) > 140 mmHg, and 24-hour systolic blood pressure < 130 mmHg; and (2) patients with normal OSBP but 24-hour SBP > 130 mmHg “MHTN”. Anthropometric measurements, together with basic cardiovascular risk factors and target organ damage assessment were performed. Results: In univariate analyses age, weight, BMI, waist circumference, as well as biochemical markers (total cholesterol, HDL, LDL-C, triglycerides, glucose levels) were comparable between the groups (P=NS, for all comparisons). MHTN patients presented with more pronounced target organ damage markers (eGFR, LVH, IMT) except for cfPWV (11.4 vs. 9.6 m/s for WCHT vs. MHTN, respectively; P<0.001). Nevertheless, the multivariate analysis adjusted to the levels of OSBP, HR and age showed marked attenuation of the observed PWV difference (P=0.84 for the model). Conclusion: Single time office pulse wave velocity measurement in white coat effect presenting patients may not be a sufficient tool for the accurate assessment of subclinical damage. Thus sequential PWV measurement or other methods should be considered in this group of patients.