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Assessment of target-organ damage in adolescent white-coat and sustained hypertensives

Aims and scope The aim of the present study was to assess whether a difference exists between intima–media thickness and the left ventricular mass index in healthy nonhypertensive, white-coat hypertensive and sustained hypertensive adolescents. Patients and methods Fifty-nine normotensive and 120 hypertensive adolescents were enrolled in our study. Hypertensive patients were classified into white-coat hypertension (WCH) and sustained hypertension groups based on 24-h ambulatory blood pressure measurements. Both normotensive and hypertensive individuals underwent routine laboratory tests, intima–media thickness measurements on the common carotid arteries and transthoracic echocardiography to measure the left ventricular mass index (LVMI). Results Intima–media thickness was higher both in WCH and sustained hypertension compared with healthy normotensive individuals (controls: 0.048 ± 0.01 cm, WCH: 0.056 ± 0.01 cm, sustained hypertension: 0.054 ± 0.012 cm, both P < 0.001 compared with controls, nonsignificant difference between the two hypertensive groups). There was no difference between the LVMI of control individuals and WCH (LVMI: 35.5 ± 10.3 g/m2.7 and 37.7 ± 11.2 g/m2.7 respectively, P = 0.87). LVMI in sustained hypertension group (LVMI: 44.1 ± 14.1 g/m2.7) was significantly higher both compared with WCH (P < 0.05), and healthy adolescents (P < 0.001). Conclusion Target-organ damage develops in a stepwise fashion in adolescent hypertension. An increased intima–media thickness can be demonstrated not only in the sustained but also in the white-coat form of adolescent hypertension.