marmara med j

Marmara Medical Journal

1019-1941 1309-9469

Marmara University

10.5472/marumj.518986

Clinical Sciences

Klinik Tıp Bilimleri

Beyaz önlük hipertansiyonunda uç organ hasarı ile vücut kitle indeksi arasındaki ilişki

The relation between body mass index and end organ damage in white coat hypertension

Demır

Atakan

Dıncer

Mevlut Tamer

01 29 2019

32 1 50 54 09 23 2018 11 27 2018

1988

Marmara Medical Journal

Amaç: Beyaz önlük hipertansiyonu (BÖH) poliklinik ölçümlerindekan basıncının yüksek bulunması ancak ambulatuvar kan basıncıveya ev ölçümleri sırasında kan basınçlarının normal seyretmesidir.Biz bu çalışmada, obezitenin uç organ hasarına etkisini ve vücutkitle indeksi (VKİ) ile BÖH’ün neden olduğu uç organ hasarıarasındaki ilişkiyi incelemeyi amaçladık.Hastalar ve Yöntemler: Çalışmamıza polikliniğimize başkanedenlerle başvuran veya hastalık saptanmayan sağlıklı kişilerarasından hipertansiyon tanısı almamış ya da hipertansiyonnedeniyle tedavi edilmemiş olan bireyler dâhil edildi. Gündüzölçüm değerleri kriter alınarak sistolik kan basıncı 135 mmHg,diastolik kan basıncı 85 mmHg’nın altındaki değerler BÖH olarakkabul edildi. Hastalar uç organ hasarı yönünden değerlendirildi.Ekokardiografi ile sol ventrikül kitlesi (SVK) ölçüldü. Retinopatiaraştırıldı. Mikroalbuminüri düzeyine bakıldı.Bulgular: Ortalama sol ventrikül kitle indeksi (SVKİ) veSVK değerleri sırasıyla 96,29 ± 25,64 gr/m2 ve 170,87 ± 50,17gr bulundu. Hipertansif retinopati sıklığı %17’idi. Kan basıncıdeğerlerinden bağımsız olarak VKİ ile SVK ve SVKİ arasındakorelasyon bulundu.Sonuç: Beyaz önlük hipertansiyonunun masumiyeti konusundaçelişkili ifadeler vardır. Değişen kan basıncı değerlerinden bağımsızolarak farklı uç organ hasarları görülmektedir. Obez olan BÖHhastalarında kardiyak yetmezlik daha sık ve erken görülmektedir.Sonuç olarak BÖH’lü bir hasta izlenirken kan basınçlarındaanlamlı değişiklik olmaksızın uç organ hasarı oluşabilmektedir.

Objective: White coat hypertension (WCH) is characterized byblood pressure, which is high in the outpatient clinic and normaleither on ambulatory blood pressure (BP) monitoring or homeBP monitoring. In this study, our objective was to investigate theeffects of obesity on end organ damage and the correlation betweenbody mass index (BMI) and end organ damage caused by WCH.Patients and Methods: Individuals, who applied to ouroutpatient clinic due to other complaints or who were not diagnosedwith or treated for hypertension, were enrolled in our study. Basedon daytime values, systolic blood pressures below 135mmHgand diastolic blood pressures below 85mmHg were considered asWCH. The patients were examined for the findings of end organdamage. The left ventricular mass (LVM) was measured withechocardiography. Findings of hypertensive retinopathy wereevaluated and albumin levels were measured.Results: The mean left ventricular mass index (LVMI) andLVM values were 96.29±25.6g/m2 and 170.87±50.17g respectively.The rate of hypertensive retinopathy was 17%. We determineda significant correlation between BMI and LVMI independentlyfrom blood pressure levels.Conclusion: There are conflicting conclusions about the risksrelated to WCH. However, several types of end organ damagecan be observed independently from the blood pressure levels inthis group of patients. Cardiac failure is more common and hasan early onset in obese patients with WCH. In conclusion, endorgan damage may emerge during the follow-up of WCH patientswithout a significant change in the blood pressure values.

Hypertension Body Mass Index Blood Pressure

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