Turk Kardiyol Dern Ars. 2005; 33(5): 261-267

The evaluation of left ventricular diastolic function by tissue Doppler echocardiography in white-coat hypertensive individuals

Doğan Erdoğan¹, Hakan Güllü¹, Mustafa Çalışkan¹, İbrahim Yıldırım², Muhammet Bilgi¹, Haldun Müderrisoğlu^1
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OBJECTIVES
We evaluated left ventricular diastolic function using tissue Doppler imaging in cases with white-coat hypertension (WCH) and compared the results with those of sustained hypertensives.
STUDY DESIGN
The study included 32 subjects (mean age 45.1 years) with mild to moderate sustained hypertension according to the JNC VII criteria, 29 subjects (mean age 46.6 years) with WCH, and 35 normotensive healthy controls (mean age 45.5 years). None of the subjects had previously received antihypertensive treatment, nor did they have any systemic disease or risk factors for coronary artery disease. Left ventricular diastolic function was assessed by both transthoracic conventional Doppler and tissue Doppler echocardiography.
RESULTS
There were no significant differences between the two hypertension groups with respect to age, gender, body mass index, lipids and glucose levels, and office systolic and diastolic blood pressures (p>0.05). Ambulatory blood pressures were significantly higher in the sustained hypertension group than those of the other groups (p<0.05). Left ventricular diastolic parameters obtained by transthoracic conventional Doppler and tissue Doppler echocardiography were similar between the two hypertension groups (p>0.05). However, parameters found in the WCH group were different from those of the controls, some of which reached statistical significance.
CONCLUSION
Even in the absence of a systemic disease or a major risk factor for cardiac disease, WCH is associated with significant impairment in left ventricular diastolic function, similar to that seen in sustained hypertension. In case of accompanying risk factors, these subjects may well be considered to be candidates of antihypertensive treatment.

Keywords: Blood pressure monitoring, ambulatory/methods/ psychology; diastole; echocardiography, Doppler, pulsed; hypertension/ physiopathology/complications; stress, psychological; systole; ventricular dysfunction, left/physiopathology

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