Title:Elevated Left Ventricular Filling Pressure as an Early Predictor of Progression
of White-coat Hypertension to Sustained Hypertension
Volume: 5
Author(s): D. Srinivasa Rao*Sasank Durugu
Affiliation:
- Unicare Medical Centre, Burjuman, Dubai, United Arab Emirates
Keywords:
White-coat hypertension, Sustained hypertension, Left ventricular filling pressures, Mitral inflow E/E’ratio, Echocardiographic parameters, Treatment.
Abstract:
Background:
White-coat hypertension is commonly observed in subjects presenting with elevated office blood pressure measurements. Although white-coat
hypertension does not require medication long-term, studies have observed progression to sustained hypertension in about 30% of individuals. Left
ventricular diastolic abnormalities have been described in some individuals with white-coat hypertension and early hypertension.
Objective:
The present study is a prospective study of follow-up of individuals with white-coat hypertension and the correlation of left ventricular diastolic
parameters as determinants of the development of sustained hypertension.
Materials and Methods:
Individuals diagnosed to have white-coat hypertension based on elevated office blood pressure measurements and normal ambulatory blood
pressure measurements were included in the study and were evaluated by echocardiography for left ventricular diastolic function and filling
pressures (E/A ratio, E wave deceleration time, E/E’ ratio). They were followed up for 1-year to assess for the development of sustained
hypertension and to correlate with the initial echocardiographic parameters.
Results:
A total number of 32 individuals with white coat hypertension were followed up for 1 year period. Moreover, 25 (78.12%) subjects remained to be
normotensive and 7 (21.88%) subjects developed sustained hypertension. There was no significant correlation between E/A, and E wave
deceleration time in all the subjects. E/E’ ratio had a positive correlation (R-value 0.77) in subjects who developed sustained hypertension over a 1-
year follow-up.
Conclusion:
Echocardiographic evaluation of left ventricular filling pressure by E/E’ ratio can be considered as an early predictor for the development of
sustained hypertension in white-coat hypertension in a long-term follow-up.
