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Drazich_06_BGS_CV_2019_v4 (1).pdf (176.76 kB)

White coat hypertension is associated with increased small vessel disease in the brain

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posted on 2023-06-09, 20:47 authored by E Drazich, S Vundavalli, F Kirkham, P Rankin, J Timeyin, E Bunting, Khalid Mustafa AliKhalid Mustafa Ali, Chakravarthi RajkumarChakravarthi Rajkumar
Objective: Small vessel disease, as measured by white matter hyperintensity (WMH) in the brain, is known to be associated with increased stroke risk and cognitive impairment. This study explored the relationship between WMH on computerised tomography (CT) and white coat hypertension/effect (WCH/E) in patients with recent transient ischaemic attack (TIA) or lacunar stroke (LS). Design and method: Ninety-six patients recruited for the ASIST trial (Arterial Stiffness in Lacunar Stroke and TIA) underwent measurement of clinic blood pressure (BP) and ambulatory BP monitoring (APBM) within two weeks of TIA or LS. Twenty-three patients had normotension (clinic BP < 140/90mmHg and day-time ABPM < 135/85mmHg) and 25 patients had WCH/E (clinic BP >/ = 140/90mmHg and day-time ABPM < 135/85mmHg). Arterial stiffness was measured using carotid-femoral pulse wave velocity (PWV) (Complior®, ALAM Medical) and carotid-ankle vascular index (CAVI) (VaSera VS-1500N®, Fukuda Denshi). CT images were scored for WMH using the four-point Fazekas visual rating scale. Patients were grouped into no-mild WMH (scores 0–1) or moderate-severe (scores 2–3) groups. The relationship between BP, vascular stiffness and WMH was explored with t-tests, chi-square and logistic regression accounting for known cardiovascular risk factors. Results: Forty-four percent of patients with WCH/E had moderate-severe WMH compared to 17% of normotensives (p = 0.047). The regression model with WMH as the dependent factor, and WCH/E and cardiovascular risk factors as independent factors showed WCH/E and either CAVI or PWV to be the only independent significant factor contributing to WMH (CAVI:p = 0.038, PWV:p = 0.043).


Publication status

  • Published

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  • Published version

Event name

BGS conference

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Event date

25 Jan 2019

Department affiliated with

  • Clinical and Experimental Medicine Publications


Awarded third prize in London. This poster was also presented at: The ESH conference 21-23 June 2019 in Milan

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