P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?
Objective: International guidelines advocate conservative management of post-stroke white coat hypertension. The aims of this study were to investigate; i) does WCH/E result in increased stroke risk? and ii) is WCH/E associated with surrogate markers of cardiovascular risk? Methods: The Arterial St...
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doaj-a46b7b9893684f7d9fce685337d42dce2020-11-25T02:50:45ZengAtlantis PressArtery Research 1876-44012020-02-0125110.2991/artres.k.191224.141P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management?Fran KirkhamGN NurediniA SaundersErin DrazichEva BuntingPhilip RankinK AliM OkorieChakravarthi RajkumarObjective: International guidelines advocate conservative management of post-stroke white coat hypertension. The aims of this study were to investigate; i) does WCH/E result in increased stroke risk? and ii) is WCH/E associated with surrogate markers of cardiovascular risk? Methods: The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of transient ischaemic attack (TIA) or lacunar stroke in the preceding 14 days. Patients were grouped by BP phenotypes. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension, 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. Other surrogate markers measured were; Central aortic BP (SphygoCor, AtCor Medical), QKD100-60 interval and nocturnal dipping status (Diasys Integra II, Novocor). Results: Compared to the normotensive cohort, patients with WCH/E were older, had a higher body mass index (BMI) and a larger proportion of patients were on anti-hypertensive medication. Both central systolic (145 ± 13 vs 118 ± 8, p < 0.001) and diastolic BP (82 ± 8 vs 76 ± 7, p = 0.004) were higher in WCH/E. The WCH/E cohort also had more lacunar strokes (p = 0.039) (Table 1). Conclusion: In this population of post-stroke patients, WCH/E was associated with higher prevalence of lacunar stroke. These individuals also had higher central pressures despite more patients being on anti-hypertensive treatment, suggesting that post-stroke WCH/E should be managed more aggressively. Normotension (N = 32) WCH/E (N = 30) Significance Male, n (%) 21 (66) 22 (73) 0.511 Age (years) 69.9 ± 11.5 75.7 ± 9 3 0.033 BMI (kg/m2) 25 ± 4 28 ± 4 0.014 Anti-hypertensive use, n (%) 19 (59) 23 (77) 0.146 Clinic SBP (mmHg) 125 ± 9 155 ± 13 <0.001 Clinic DBP (mmHg) 75 ± 7 81 ± 8 0.003 Daytime systolic ABPM (mmHg) 114 ± 10 121 ± 10 0.007 Daytime diastolic ABPM (mmHg) 73 ± 7 72 ± 7 0.586 Central SBP (mmHg) 118 ± 8 145 ± 13 <0.001 Central DBP (mmHg) 76 ± 7 82 ± 8 0.004 QKD100−60 interval (msec) 208 ± 18 197 ± 26 0.114 Non-dipper, n (%) 16 (57) 14 (50) 0.592 Stroke type TIA, n (%) 25 (78) 16 (53) 0.039 Lacunar, n (%) 7 (22) 14 (47) Data expressed as mean ± standard deviation or number (percentage). Significance determined by t-test. Chi-squared used for: anti-hypertensive use, male gender, dipping status and stroke type.https://www.atlantis-press.com/article/125934571/view |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fran Kirkham GN Nuredini A Saunders Erin Drazich Eva Bunting Philip Rankin K Ali M Okorie Chakravarthi Rajkumar |
spellingShingle |
Fran Kirkham GN Nuredini A Saunders Erin Drazich Eva Bunting Philip Rankin K Ali M Okorie Chakravarthi Rajkumar P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? Artery Research |
author_facet |
Fran Kirkham GN Nuredini A Saunders Erin Drazich Eva Bunting Philip Rankin K Ali M Okorie Chakravarthi Rajkumar |
author_sort |
Fran Kirkham |
title |
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? |
title_short |
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? |
title_full |
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? |
title_fullStr |
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? |
title_full_unstemmed |
P115 Does Post-stroke White Coat Hypertension/Effect (WCH/E) Require Intensive Blood Pressure Management? |
title_sort |
p115 does post-stroke white coat hypertension/effect (wch/e) require intensive blood pressure management? |
publisher |
Atlantis Press |
series |
Artery Research |
issn |
1876-4401 |
publishDate |
2020-02-01 |
description |
Objective: International guidelines advocate conservative management of post-stroke white coat hypertension. The aims of this study were to investigate; i) does WCH/E result in increased stroke risk? and ii) is WCH/E associated with surrogate markers of cardiovascular risk?
Methods: The Arterial Stiffness In Lacunar Stroke and TIA (ASIST) study recruited 96 patients, aged over 40 years old, with a confirmed diagnosis of transient ischaemic attack (TIA) or lacunar stroke in the preceding 14 days. Patients were grouped by BP phenotypes. Thirty-four patients were excluded (n = 6 declined ABPM, n = 3 masked hypertension, 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. Other surrogate markers measured were; Central aortic BP (SphygoCor, AtCor Medical), QKD100-60 interval and nocturnal dipping status (Diasys Integra II, Novocor).
Results: Compared to the normotensive cohort, patients with WCH/E were older, had a higher body mass index (BMI) and a larger proportion of patients were on anti-hypertensive medication. Both central systolic (145 ± 13 vs 118 ± 8, p < 0.001) and diastolic BP (82 ± 8 vs 76 ± 7, p = 0.004) were higher in WCH/E. The WCH/E cohort also had more lacunar strokes (p = 0.039) (Table 1).
Conclusion: In this population of post-stroke patients, WCH/E was associated with higher prevalence of lacunar stroke. These individuals also had higher central pressures despite more patients being on anti-hypertensive treatment, suggesting that post-stroke WCH/E should be managed more aggressively.
Normotension (N = 32)
WCH/E (N = 30)
Significance
Male, n (%)
21 (66)
22 (73)
0.511
Age (years)
69.9 ± 11.5
75.7 ± 9 3
0.033
BMI (kg/m2)
25 ± 4
28 ± 4
0.014
Anti-hypertensive use, n (%)
19 (59)
23 (77)
0.146
Clinic SBP (mmHg)
125 ± 9
155 ± 13
<0.001
Clinic DBP (mmHg)
75 ± 7
81 ± 8
0.003
Daytime systolic ABPM (mmHg)
114 ± 10
121 ± 10
0.007
Daytime diastolic ABPM (mmHg)
73 ± 7
72 ± 7
0.586
Central SBP (mmHg)
118 ± 8
145 ± 13
<0.001
Central DBP (mmHg)
76 ± 7
82 ± 8
0.004
QKD100−60 interval (msec)
208 ± 18
197 ± 26
0.114
Non-dipper, n (%)
16 (57)
14 (50)
0.592
Stroke type
TIA, n (%)
25 (78)
16 (53)
0.039
Lacunar, n (%)
7 (22)
14 (47)
Data expressed as mean ± standard deviation or number (percentage). Significance determined by t-test. Chi-squared used for: anti-hypertensive use, male gender, dipping status and stroke type. |
url |
https://www.atlantis-press.com/article/125934571/view |
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