Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension: Data froma general population

Cesare Cuspidi, Rita Facchetti, Michele Bombelli, Carlac Sala, Marijana Tadic, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim: In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting newonset metabolic syndrome (MetS). Methods: The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat hypertension (WCH), masked hypertension and sustained hypertension. Results: Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR=1.75, CI 1.01-3.04, P=0.0046), masked hypertension (OR=2.58, CI 1.26-5.30; P=0.009) and sustained hypertension (OR=2.14, CI 1.20-3.79, P=0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-ofoffice BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P=0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion: Our study provides evidence that either isolated or combined BP elevations identified by office/ ambulatory measurements, carry an increased risk of newonset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

Original languageEnglish
Pages (from-to)1833-1839
Number of pages7
JournalJournal of Hypertension
Volume36
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

Fingerprint

White Coat Hypertension
Blood Pressure
Population
Masked Hypertension
Hypertension
Phenotype
Abdominal Obesity
Age of Onset
Hyperglycemia

Keywords

  • General population
  • Metabolic syndrome
  • Office and out-of-office blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension : Data froma general population. / Cuspidi, Cesare; Facchetti, Rita; Bombelli, Michele; Sala, Carlac; Tadic, Marijana; Grassi, Guido; Mancia, Giuseppe.

In: Journal of Hypertension, Vol. 36, No. 9, 01.09.2018, p. 1833-1839.

Research output: Contribution to journalArticle

Cuspidi, Cesare ; Facchetti, Rita ; Bombelli, Michele ; Sala, Carlac ; Tadic, Marijana ; Grassi, Guido ; Mancia, Giuseppe. / Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension : Data froma general population. In: Journal of Hypertension. 2018 ; Vol. 36, No. 9. pp. 1833-1839.
@article{7f3d0db8e1c44c5c987ae32c296d59bf,
title = "Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension: Data froma general population",
abstract = "Aim: In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting newonset metabolic syndrome (MetS). Methods: The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat hypertension (WCH), masked hypertension and sustained hypertension. Results: Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR=1.75, CI 1.01-3.04, P=0.0046), masked hypertension (OR=2.58, CI 1.26-5.30; P=0.009) and sustained hypertension (OR=2.14, CI 1.20-3.79, P=0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-ofoffice BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P=0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion: Our study provides evidence that either isolated or combined BP elevations identified by office/ ambulatory measurements, carry an increased risk of newonset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.",
keywords = "General population, Metabolic syndrome, Office and out-of-office blood pressure",
author = "Cesare Cuspidi and Rita Facchetti and Michele Bombelli and Carlac Sala and Marijana Tadic and Guido Grassi and Giuseppe Mancia",
year = "2018",
month = "9",
day = "1",
doi = "10.1097/HJH.0000000000001767",
language = "English",
volume = "36",
pages = "1833--1839",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension

T2 - Data froma general population

AU - Cuspidi, Cesare

AU - Facchetti, Rita

AU - Bombelli, Michele

AU - Sala, Carlac

AU - Tadic, Marijana

AU - Grassi, Guido

AU - Mancia, Giuseppe

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Aim: In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting newonset metabolic syndrome (MetS). Methods: The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat hypertension (WCH), masked hypertension and sustained hypertension. Results: Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR=1.75, CI 1.01-3.04, P=0.0046), masked hypertension (OR=2.58, CI 1.26-5.30; P=0.009) and sustained hypertension (OR=2.14, CI 1.20-3.79, P=0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-ofoffice BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P=0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion: Our study provides evidence that either isolated or combined BP elevations identified by office/ ambulatory measurements, carry an increased risk of newonset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

AB - Aim: In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting newonset metabolic syndrome (MetS). Methods: The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat hypertension (WCH), masked hypertension and sustained hypertension. Results: Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR=1.75, CI 1.01-3.04, P=0.0046), masked hypertension (OR=2.58, CI 1.26-5.30; P=0.009) and sustained hypertension (OR=2.14, CI 1.20-3.79, P=0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-ofoffice BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P=0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion: Our study provides evidence that either isolated or combined BP elevations identified by office/ ambulatory measurements, carry an increased risk of newonset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

KW - General population

KW - Metabolic syndrome

KW - Office and out-of-office blood pressure

UR - http://www.scopus.com/inward/record.url?scp=85049384595&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049384595&partnerID=8YFLogxK

U2 - 10.1097/HJH.0000000000001767

DO - 10.1097/HJH.0000000000001767

M3 - Article

AN - SCOPUS:85049384595

VL - 36

SP - 1833

EP - 1839

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 9

ER -