WHITE-COAT HYPERTENSION AND ARTERIAL STIFFNESS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Objective: Our aim was to analyze cardiovascular (CV) risk factors, target-organ damage, arterial stiffness and ABPM in patients with inflammatory bowel disease (IBD). Design and method: A total of 120 IBD patients (77 Crohn; 43 ulcerative colitis; age 37.1 ± 4.2; men 58.3%) were enrolled. Office blood pressure (BP) (Omron M6), pulse wave velocity (PWV) and aortic augmentation index (AIx) (Arteriograph) and ABPM (SpaceLab 90207) were measured in all patients. Hypertension was defined as BP > 140/90 mmHg. None of patients used antihypertensive drugs. Chronic kidney disease (CKD) = eGFR < 60 ml/min/1.73m2 (CKD Epi); microalbuminuria (MA) = 24-h albuminuria > 30 mg/dU. Results: Dyslipidemia, left ventricular hypertrophy, CKD and MA were found in 10%, 0.83%,1.67% and 15% of patients, respectively. PWV > 8m/s was found in 45% of patients. In the linear regression model age and duration of IBD were only positive predictors of higher PWV. On logistic regression older patients and patients with longer duration of IBD had OŔs for PWV > 8 m/s of 0.94 [CI 0.89, 0.99] and 0.99 [CI 0.98, 1.00]. In the whole group of patients older age and longer duration of IBD had OŔs for TOD (0.93 [CI 0.89, 0.96]; 0.99 [CI 0.98, 1.00]). White coat hypertension (WCH) was found in 38 subjects (31.7%), while 1 patient had masked hypertension. There were 41.7% non-dippers. We failed to find differences in traditional CV risk factors between WCH and normotensives. However, patients with WCH had significantly higher values of central systolic BP, AIx and PWV. PWV and non-dipping pattern were associated with WCH (OR 0.69 [CI 0.52, 0.92] and 2.50 [CI 1.08, 5.77]. Conclusions: The most important finding of our study is high prevalence of WCH which was associated with PWV, Aix and higher central systolic BP. The second important result is higher prevalence of patients with PWV above the cut off value which was associated with age and the duration of IBD but not with other traditional risk factors. We confirmed that traditional CV risk factors are not frequently present in IBD patients indicating that inflammation is important determinant of arterial stiffness in IBD.