P116 Post-stroke White Coat Hypertension/Effect is Associated with Greater Arterial Stiffness

Abstract

Objective

White coat hypertension/effect (WCH/E) describes an elevated clinic blood pressure (BP) with normal daytime ambulatory BP (ABPM) values. It is not clear whether WCH/E is associated with adverse vascular risk. This study aimed to determine the relationship between WCH/E and arterial stiffness in a cohort of patients who had a transient ischaemic attack (TIA) or lacunar stroke (LS).

Design and Method

The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of TIA or LS in the preceding 14 days. Patients were grouped by BP. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension and n = 25 sustained hypertension). Thirty-two patients with normal BP (clinic BP < 140/90 mmHg and day-time ABPM < 135/85 mmHg), and 30 patients with WCH/E (clinic BP > 140/90 mmHg and day-time ABPM < 135/85 mmHg) were recruited. Arterial stiffness was measured using carotid-femoral pulse wave velocity (PWV), (Complior^®, ALAM Medical) and carotid-ankle vascular index (CAVI), (VaSera VS-1500 N®, Fukuda Denshi).

Results

Compared to patients with normal BP, patients with WCH/E were older, had a higher body mass index (BMI) and higher arterial stiffness measured by CAVI (10.3 ± 1.3 vs 9.4 ± 1.7, p = 0.027), and PWV (11.9 ± 3.0 vs 9.6 ± 2.3 ms⁻¹, p = 0.002). The WCH/E cohort had more lacunar strokes (p = 0.039).

Conclusion

In this population of post-stroke patients, those with WCH/E had greater arterial stiffness and a higher prevalence of lacunar stroke. These results suggest that WCH/E is associated with adverse cardiovascular risk.

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