Isolated clinic hypertension is not an innocent phenomenon - Effect on thecarotid artery structure

This study examines the common carotid intimalmedial wall thickness (CCA-IM T) in untreated patients with elevated clinic blood pressure (BP) but norma l ambulatory BP (isolated clinic hypertension, n = 22), in comparison with a group with elevated clinic and ambulatory BP (hypertensives, n = 41) and a group with normal clinic and ambulatory BP (normotensives, n = 17) readin gs. The three groups did not differ in age, male/female ratio, lipid profil e, glucose tolerance test, or smoking habits. No difference existed in CCA-IMT values between the groups with hypertensio n (0.67 +/- 0.18 mm) and isolated clinic hypertension (0.68 +/- 0.14 mm), b ut the values in these two groups were significantly higher tone-way ANOVA; F = 8.09, P < .001) than in the group of normotensives (0.50 +/- 0.09 mm). The CCA-IMT did not correlate with clinic systolic or diastolic BP reading s or with BP derivatives of 24-h ambulatory monitoring. Mean 24-h BP in the isolated clinic hypertensives did not differ from that in the normotensive s, whereas both were lower than in the hypertensives. We conclude that changes in the CCA-IMT occuring in subjects with isolated clinic hypertension are equal to the changes in sustained hypertension, ind icating that isolated clinic hypertension may not be a benign condition. (C ) 1999 American Journal of Hypertension, Ltd.