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White-coat hypertension during coronary computed tomography angiography is associated with higher coronary atherosclerotic burden.
Coron Artery Dis. 2017 Jan; 28(1):57-62.CA

Abstract

INTRODUCTION

White-coat hypertension (WCH) is a prevalent entity, which has been associated with an increased cardiovascular risk.

AIM

Assess whether WCH is associated with a higher coronary atherosclerotic burden, evaluated by coronary computed tomography angiography (CCTA) and coronary artery calcium (CAC) scoring.

METHODS

A total of 1362 patients who performed CCTA and simultaneous CAC for the assessment of coronary artery disease (CAD) were prospectively enrolled in a single-center registry and divided into three groups: (A) patients with normal blood pressure (BP) (n=386); (B) patients with WCH (n=174; without a history of hypertension or antihypertensive medication, but with systolic BP ≥140 and/or diastolic BP ≥90 mmHg before examination acquisition); and (C) patients with hypertension (n=802). The following coronary atherosclerotic markers were evaluated: CAC above the 50th percentile (CAC>p50), prevalence of CAD (any plaque), and obstructive CAD (plaque with>50% stenosis).

RESULTS

Patients with WCH had a higher coronary atherosclerotic burden compared with patients with normal BP for all markers (30.5 vs. 19.4%, P=0.004 for CAC>p50; 50.6 vs. 36.8%, P=0.002 for CAD, any plaque; and 13.8 vs. 8.3%, P=0.045 for obstructive CAD). On multivariate analysis, WCH was an independent predictor of a CAC>p50 [odds ratio (OR) 1.563, 95% confidence interval 1.018-2.400, P=0.041], but not of the presence of CAD (any plaque) (OR 1.335, P=0.169) or obstructive CAD (OR 1.376, P=0.301).

CONCLUSION

In this registry of patients, WCH was an independent predictor of a CAC above the p50. It was also associated with higher other markers of coronary atherosclerotic burden, such as the presence of CAD on CCTA, compared with patients with normal BP.

Authors+Show Affiliations

aHospital da Luz bHospital de Santa Cruz cCEDOC, Nova Medical School, Lisbon dHospital Santarém, Santarém, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27580089

Citation

Costa, Cátia, et al. "White-coat Hypertension During Coronary Computed Tomography Angiography Is Associated With Higher Coronary Atherosclerotic Burden." Coronary Artery Disease, vol. 28, no. 1, 2017, pp. 57-62.
Costa C, de Araújo Gonçalves P, Ferreira A, et al. White-coat hypertension during coronary computed tomography angiography is associated with higher coronary atherosclerotic burden. Coron Artery Dis. 2017;28(1):57-62.
Costa, C., de Araújo Gonçalves, P., Ferreira, A., Pitta, M. L., Dores, H., Cardim, N., & Marques, H. (2017). White-coat hypertension during coronary computed tomography angiography is associated with higher coronary atherosclerotic burden. Coronary Artery Disease, 28(1), 57-62.
Costa C, et al. White-coat Hypertension During Coronary Computed Tomography Angiography Is Associated With Higher Coronary Atherosclerotic Burden. Coron Artery Dis. 2017;28(1):57-62. PubMed PMID: 27580089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - White-coat hypertension during coronary computed tomography angiography is associated with higher coronary atherosclerotic burden. AU - Costa,Cátia, AU - de Araújo Gonçalves,Pedro, AU - Ferreira,António, AU - Pitta,Maria L, AU - Dores,Hélder, AU - Cardim,Nuno, AU - Marques,Hugo, PY - 2016/9/1/pubmed PY - 2017/3/30/medline PY - 2016/9/1/entrez SP - 57 EP - 62 JF - Coronary artery disease JO - Coron Artery Dis VL - 28 IS - 1 N2 - INTRODUCTION: White-coat hypertension (WCH) is a prevalent entity, which has been associated with an increased cardiovascular risk. AIM: Assess whether WCH is associated with a higher coronary atherosclerotic burden, evaluated by coronary computed tomography angiography (CCTA) and coronary artery calcium (CAC) scoring. METHODS: A total of 1362 patients who performed CCTA and simultaneous CAC for the assessment of coronary artery disease (CAD) were prospectively enrolled in a single-center registry and divided into three groups: (A) patients with normal blood pressure (BP) (n=386); (B) patients with WCH (n=174; without a history of hypertension or antihypertensive medication, but with systolic BP ≥140 and/or diastolic BP ≥90 mmHg before examination acquisition); and (C) patients with hypertension (n=802). The following coronary atherosclerotic markers were evaluated: CAC above the 50th percentile (CAC>p50), prevalence of CAD (any plaque), and obstructive CAD (plaque with>50% stenosis). RESULTS: Patients with WCH had a higher coronary atherosclerotic burden compared with patients with normal BP for all markers (30.5 vs. 19.4%, P=0.004 for CAC>p50; 50.6 vs. 36.8%, P=0.002 for CAD, any plaque; and 13.8 vs. 8.3%, P=0.045 for obstructive CAD). On multivariate analysis, WCH was an independent predictor of a CAC>p50 [odds ratio (OR) 1.563, 95% confidence interval 1.018-2.400, P=0.041], but not of the presence of CAD (any plaque) (OR 1.335, P=0.169) or obstructive CAD (OR 1.376, P=0.301). CONCLUSION: In this registry of patients, WCH was an independent predictor of a CAC above the p50. It was also associated with higher other markers of coronary atherosclerotic burden, such as the presence of CAD on CCTA, compared with patients with normal BP. SN - 1473-5830 UR - https://www.unboundmedicine.com/medline/citation/27580089/White_coat_hypertension_during_coronary_computed_tomography_angiography_is_associated_with_higher_coronary_atherosclerotic_burden_ L2 - https://doi.org/10.1097/MCA.0000000000000424 DB - PRIME DP - Unbound Medicine ER -