Studies on the brain event related potentials in the elderly with white-coat or isolated systolic hypertension

The aim of this study was to investigate brain organ damage or cerebral alt erations in elderly subjects with white coat systolic hypertension (WCH), i solated systolic hypertension (ISH) and normotensives (N), to verify the cl inical significance of WCH. Thirty elderly untreated subjects were subdivid ed, after clinical measurement of their arterial blood pressure values acco rding to the WHO Guidelines, and 24 hrs ambulatory blood pressure monitorin g (ABPM), in three groups: 10 N, 10 WCH and 10 ISH patients. All the patien ts were submitted to mini mental state examination (MMSE) and recording of event-related potentials (ERP), determination of N2 (an index of early func tional cognitive alterations) and P300 (an index of clinically evident cogn itive deficit). We did not observe statistically significant differences am ong the three groups as regards the lag-time of the P300 potential and MMSE scores. The lag-time of the N2 wave showed a significant difference betwee n the normotensives and ISH patients, but did not between the N or ISH and WCH groups. The lag-time of N2 in WCH being intermediate between the other two groups, could be ascribed to higher blood pressure variability, and pre dicts future cognitive impairment.