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<p>Hypertension phenotypes reflect the agreement or disagreement between office and out-of-office blood pressure (BP) measurements and are challenging to distinguish during a single office visit. Increased sympathetic nervous system (SNS) activity is implicated in their pathophysiology. Aortic valve peak velocity, an echocardiographic parameter associated with SNS hyperactivity and high cardiac output states, may help differentiate hypertension phenotypes. This study examined the association between hypertension phenotypes and aortic valve peak velocity. Cross-sectional analysis of consecutive patients evaluated at a reference Hypertension Unit who underwent office (OBP), ambulatory BP (ABP) monitoring, and echocardiography. A total of 384 participants were included (mean age 58 years; 55% male; 60% treated systolic/diastolic OBP 136/84 mmHg, ABP 126/77 mmHg, aortic valve peak velocity 1.31 m/s, 34% normotension/controlled hypertension, 18% white-coat hypertension/white-coat uncontrolled hypertension (WCH/WCUH), 16% masked hypertension/masked uncontrolled hypertension, 32% sustained hypertension/uncontrolled hypertension]. Aortic valve peak velocity was significantly higher in the WCH/WCUH group (1.40 ± 0.26 m/s) compared with all other phenotypes (<i>P</i> &lt; 0.01). This finding was consistent in analyses restricted to untreated patients and to those with a short ABP-echocardiography time interval, and remained significant in multivariable linear regression models. Among participants with office hypertension, a cut-off value of 1.32 m/s demonstrated moderate diagnostic accuracy for identifying WCH/WCUH (sensitivity 62%, specificity 66%). Aortic valve peak velocity is significantly elevated in WCH/WCUH and may serve as a supportive clinical tool to help identify or exclude this phenotype in patients presenting with office hypertension, particularly in untreated individuals undergoing baseline echocardiography.</p><p></p>

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Association between hypertension phenotypes and aortic valve peak velocity: a potential tool for identifying white-coat hypertension

  • 期刊论文

  • 发表日期：

    2026年7月1日

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  • Dimitrios Konstantinidis,
  • Konstantinos G. Kyriakoulis,
  • Georgios Papadopoulos,
  • Angeliki Vakka,
  • Konstantia Papadomarkaki,
  • Panagiotis Iliakis,
  • Kyriakos Dimitriadis,
  • Konstantinos Tsioufis

摘要

Hypertension phenotypes reflect the agreement or disagreement between office and out-of-office blood pressure (BP) measurements and are challenging to distinguish during a single office visit. Increased sympathetic nervous system (SNS) activity is implicated in their pathophysiology. Aortic valve peak velocity, an echocardiographic parameter associated with SNS hyperactivity and high cardiac output states, may help differentiate hypertension phenotypes. This study examined the association between hypertension phenotypes and aortic valve peak velocity. Cross-sectional analysis of consecutive patients evaluated at a reference Hypertension Unit who underwent office (OBP), ambulatory BP (ABP) monitoring, and echocardiography. A total of 384 participants were included (mean age 58 years; 55% male; 60% treated systolic/diastolic OBP 136/84 mmHg, ABP 126/77 mmHg, aortic valve peak velocity 1.31 m/s, 34% normotension/controlled hypertension, 18% white-coat hypertension/white-coat uncontrolled hypertension (WCH/WCUH), 16% masked hypertension/masked uncontrolled hypertension, 32% sustained hypertension/uncontrolled hypertension]. Aortic valve peak velocity was significantly higher in the WCH/WCUH group (1.40 ± 0.26 m/s) compared with all other phenotypes (P < 0.01). This finding was consistent in analyses restricted to untreated patients and to those with a short ABP-echocardiography time interval, and remained significant in multivariable linear regression models. Among participants with office hypertension, a cut-off value of 1.32 m/s demonstrated moderate diagnostic accuracy for identifying WCH/WCUH (sensitivity 62%, specificity 66%). Aortic valve peak velocity is significantly elevated in WCH/WCUH and may serve as a supportive clinical tool to help identify or exclude this phenotype in patients presenting with office hypertension, particularly in untreated individuals undergoing baseline echocardiography.