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Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

Journal of Human Hypertension volume 21, pages 854–860 (2007)Cite this article

Abstract

Some reports have suggested that white-coat hypertension (WCH) is associated with some features of the metabolic syndrome (MetS). These metabolic disturbances, instead of WCH per se, may potentially explain the greater extent of end-organ damage sometimes observed in WCH subjects (WCHs) when compared to normotensive individuals (NTs). The aim of the present cross-sectional study was to compare left ventricular (LV) structure and function in three groups of subjects: WCHs with MetS, WCHs without MetS and NTs. A total of 145 WCHs, 35% of whom had MetS, were enrolled. As controls, 35 NTs were also studied. In all subjects, routine blood chemistry, echocardiographic examination and 24-h ambulatory blood pressure monitoring were performed. When compared with WCHs without MetS, those with MetS showed higher LV mass indexed by height elevated by a power of 2.7 (LVMH2.7) (49.6±14.8 vs 38.9±9.8 g/m2.7; P<0.0001). The same parameter was greater in WCHs without MetS than in NTs (32±8 g/m2.7; P=0.004). Moreover, the E-wave deceleration time was longer in WCHs with MetS than in those without it (236.2±66.4 vs 200.5±30.8 ms; P<0.0001). The relationship of MetS with LVMH2.7 was confirmed in multivariate regression models. Our results seem to suggest that MetS may have a deleterious influence on LV structure and function in WCH. However, WCH, being associated with an increased LV mass, also in subjects without MetS, may not be considered as an innocuous phenomenon.

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Acknowledgements

This work was supported in part by a grant from the Italian Ministry for University and Scientific Research (MURST). We express our gratitude to Mrs Concetta Truscello, Mr Giuseppe Patricolo and Mrs Rosa Anello for their nursing assistance.

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  1. Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Unità Operativa di Medicina Interna, Nefrologia ed Ipertensione Università di Palermo, Palermo, Italy

    G Mulè, E Nardi, S Cottone, P Cusimano, F Incalcaterra, A Palermo, M Giandalia, C Geraci, S Buscemi & G Cerasola

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  1. G Mulè
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  2. E Nardi
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Correspondence to G Mulè.

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Mulè, G., Nardi, E., Cottone, S. et al. Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function. J Hum Hypertens 21, 854–860 (2007). https://doi.org/10.1038/sj.jhh.1002238

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