Comparison of Pulse Wave Analysis Between Persons With White Coat Hypertension and Normotensive Persons

Wimmer, Neil J MD
Sathi, Kinji BS
Chen, Tiffany L BS
Townsend, Raymond R MD
Cohen, Debbie L MD

From the Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA

Address for correspondence: Debbie L. Cohen, MD, Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine, 210 White Building, 3400 Spruce Street, Philadelphia, PA 19104 E-mail: [email protected]

Manuscript received February 13, 2007; revised April 18, 2007; accepted April 23, 2007

Journal of Clinical Hypertension 9(7):p 513-517, July 2007.

White coat hypertension (WCH) is considered by some but not all investigators to be a benign condition without increased cardiovascular risk. Pulse wave analysis is a noninvasive method to measure how the reflected pressure wave interacts with central aortic blood pressure (BP) and to assess how it is related to vascular stiffness. The purpose of the study was to compare central aortic BP in normotensive and WCH participants. WCH participants were identified after ambulatory BP monitoring. Normotensive participants served as controls. Using radial artery applanation tonometry, aortic pulse wave analysis was performed. Augmentation index (AI), AI₇₅, and differences in systolic BP between central aortic and peripheral vasculatures were calculated. Results show a difference in AI, AI₇₅, (AI standardized to a heart rate of 75 beats per minute), and central aortic systolic pressures between WCH and normotensive participants. The WCH group had significantly higher systolic BP and pulse pressure; however, these were still within the normal range. In summary, WCH participants had increased central aortic pressures compared with normotensives, supporting the potential for increased cardiovascular risk in WCH.