The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index.
Sympathetic neural mechanisms in white-coat hypertension
Open accessAbstract
Objectives This study planned to establish whether sympathetic hyperactivity exists in white-coat hypertension (WHT) in the clinical setting, relative to matched groups with normotension (NT) and untreated essential hypertension (EHT).Background White-coat hypertension differs from EHT by the presence of normal ambulatory blood pressure. Sympathetic hyperactivity exists in patients with EHT in the clinical setting and is believed to contribute to the development of target organ damage. Similar organ damage has been reported in WHT, yet little is known about sympathetic neural activity in this condition.Methods Using microneurography, we examined groups of 12 matched subjects with WHT, EHT and NT during the same clinical setting to quantify muscle sympathetic nerve activity as multiunit discharge (MSNA) and single units (s-MSNA).Results The s-MSNA in WHT (54 +/- 4.2 impulses/100 beats) was greater (p < 0.05) than in NT (37 +/- 5.4 impulses/100 beats) despite similar age and body mass index (BMI). The EHT values of s-MSNA (73 +/- 5.2 impulses/100 beats) were significantly (p < 0.05) greater than in WHT despite similar age, BMI and blood pressure levels. The MSNA followed a similar trend. White-coat hypertension had a similar cardiac baroreceptor reflex sensitivity to NT, but this was impaired in EHT relative to both NT and WHT.Conclusions It was shown, in the clinical setting, that central sympathetic hyperactivity exists in WHT, albeit to a lesser degree than EHT. These findings suggest that WHT may not be entirely benign and that the observed sympathetic hyperactivity may be responsible for development of target organ damage in this group of patients.
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“As far as the second issue is concerned, microneurographic studies almost universally shown that sympathetic nerve traffic is potentiated in established hypertension in middle age and in elderly as well as young patients38–46.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [41]
In the citing paper
“The sympathetic neural outflow is commonly activated also to the heart, shown with selective cardiac norepinephrine spillover measurements28, and to the skeletal muscle vasculature, demonstrated with microneurographic nerve traffic recording32,33,38–46, but it is the renal sympathetic activation which is central to hypertension pathogenesis96–97.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [41]
Citations
Cites
Sahn, D. J., DeMaria, A. N., KISSLO, J. A., & Weyman, A. E. (1978) · Circulation · doi:10.1161/01.cir.58.6.1072 · Cited by 7,430
Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings
Devereux, R. B., Alonso, D. R., Lutas, E. M., Gottlieb, G. J., Campo, E., Sachs, I., & Reichek, N. (1986) · The American Journal of Cardiology · doi:10.1016/0002-9149(86)90771-x · Cited by 6,226
(1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440420033005 · Cited by 3,777
Physiological aspects of primary hypertension.
Folkow, B. (1982) · Physiological Reviews · doi:10.1152/physrev.1982.62.2.347 · Cited by 1,768
Somatosensory, proprioceptive, and sympathetic activity in human peripheral nerves
Vallbo, A. B., Hagbarth, K. E., Torebjork, H. E., & Wallin, B. G. (1979) · Physiological Reviews · doi:10.1152/physrev.1979.59.4.919 · Cited by 1,507
Baroreflex Control of Sympathetic Nerve Activity in Essential and Secondary Hypertension
Grassi, G., Cattaneo, B. M., Seravalle, G., Lanfranchi, A., & Mancia, G. (1998) · Hypertension · doi:10.1161/01.hyp.31.1.68 · Cited by 526
Sympathetic Activation in the Pathogenesis of Hypertension and Progression of Organ Damage
Mancia, G., Grassi, G., Giannattasio, C., & Seravalle, G. (1999) · Hypertension · doi:10.1161/01.hyp.34.4.724 · Cited by 471
How to assess sympathetic activity in humans
Grassi, G., & Esler, M. (1999) · Journal of Hypertension · doi:10.1097/00004872-199917060-00001 · Cited by 455
Age and gender influence muscle sympathetic nerve activity at rest in healthy humans.
Ng, A. V., Callister, R. J., Johnson, D. G., & Seals, D. R. (1993) · Hypertension · doi:10.1161/01.hyp.21.4.498 · Cited by 444
The variability of muscle nerve sympathetic activity in resting recumbent man
Sundlöf, G., & Wallin, B. G. (1977) · The Journal of Physiology · doi:10.1113/jphysiol.1977.sp012050 · Cited by 442
Research works printed but not linked: 1
- Middeke, 1996, Office hypertension, Blood Press Monit, 1, 403
Cited by
Sorted by citations
Items 101–146 of 146
White Coat Effect: Is It Because of the Hospital Setting, or Is It Physician-Induced?
Singh, M., Singh, N., Pahuja, H., Arora, R., ., A., & Patel, H. (2023) · Cureus · doi:10.7759/cureus.38144 · Cited by 3
Chotruangnapa, C., & Thongdang, P. (2023) · Siriraj Medical Journal/San Sirirat · doi:10.33192/smj.v75i6.261881 · Cited by 3
White coat phenomenon, anxiety and endothelial function in healthy normotensive elderly subjects
Murata, T., Narita, K., Hamada, T., Takahashi, T., Omori, M., Yoshida, H., & Wada, Y. (2006) · Blood Pressure · doi:10.1080/08037050600693381 · Cited by 3
Prochnau, D., Figulla, H. R., & Surber, R. (2013) · Expert Review of Medical Devices · doi:10.1586/erd.13.1 · Cited by 3
Mizuno, J., Kato, S., Arita, H., Hanaoka, K., Kiuchi, Y., & Kurihara, T. (2020) · Anaesthesiology Intensive Therapy · doi:10.5114/ait.2020.93755 · Cited by 3
Сергеевна, Н. Е., Чулков, В. С., & Сергеевич, Ч. В. (2025) · South Russian Journal of Therapeutic Practice · doi:10.21886/2712-8156-2025-6-1-51-58 · Cited by 2
Hipertensión arterial de bata blanca o clínica aislada
del Rey, R. H., & Armario, P. (2003) · Hipertensión y Riesgo Vascular · doi:10.1016/s1889-1837(03)71410-x · Cited by 2
Shetty, A., Narasimhamurthy, S. S., Nataraj, K. S., Prabhu, S. M., Jagadeesh, N., Katre, K., Kumar, S., Kapoor, N., Prabhu, S. H., & Gulati, S. (2025) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1257_24 · Cited by 1
Sympathetic and Renin–Angiotensin Activity in the Pathophysiology of Hypertension
Covic, A. C., & Segall, L. (2015) · Springer eBooks · doi:10.1007/978-3-319-15961-4_35 · Cited by 1
Gilyarevsky, S. R. (2014) · Systemic Hypertension · doi:10.26442/sg29059 · Cited by 1
White, D. W., & Fernhall, B. (2015) · Molecular and translational medicine · doi:10.1007/978-3-319-17076-3_9 · Cited by 1
Update on Essential Hypertension
Salazar‐Sánchez, L. (2016) · InTech eBooks · doi:10.5772/61565 · Cited by 1
Peripheral Adrenergic Blockers
Barrett, O., & Wolak, T. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-42973-3.00023-8 · Cited by 1
Blood Pressure Measurement, White-Coat and Masked Hypertension
Seravalle, G., Grassi, G. M., & Mancia, G. (2018) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-319-75310-2_27 · Cited by 1
Seravalle, G., Brambilla, G., Pizzala, D. P., & Grassi, G. M. (2018) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-319-59918-2_6 · Cited by 1
Alcalá‐Cerra, G. (2007) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 1
Blood pressure control and therapeutic modulation of the adrenergic overdrive
Grassi, G. M., & Trevano, F. Q. (2007) · Current Hypertension Reports · doi:10.1007/s11906-007-0029-z · Cited by 1
Estimation of Base Blood Pressure by Using a New Device in the Outpatient Clinic
Tochikubo, O., Kura, N., TOKITA, H., Sakon, S., & Nishijima, K. (2006) · Hypertension Research · doi:10.1291/hypres.29.233 · Cited by 1
Mansoor, G. A., & White, W. B. (2005) · Elsevier eBooks · doi:10.1016/b978-0-7216-0258-5.50118-6 · Cited by 1
Curie, M., Epidémiologie, S., Cacciolati, C., Berr, C., Guillaume, M., Pascal, M., Examinateur, A., Jean-michel, M., Examinateur, M., Jean-jacques, M., et al. (2005) · Revue du Rhumatisme · doi:10.1016/j.rhum.2005.10.003 · Cited by 1
Cacciolati, C. (2012) · OpenGrey (Institut de l'Information Scientifique et Technique)
Participação do óxido nítrico na hipertensão do avental branco
Marchi-Alves, L. M. (2006) · doi:10.11606/t.22.2006.tde-17012007-154726
Challenges in the diagnosis of arterial hypertension in consulting room
Quiroz, G. D. (2006) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Bases fisiológicas de la hipertensión arterial de bata blanca
Hernández, Y. I. (2009) · Revista Médica de la Universidad de Costa Rica · doi:10.15517/rmu.v3i2.7839
50 Years Ago in The Journal of Pediatrics
deRegnier, R.-A. O. (2007) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2006.11.016
El efecto de bata blanca sobre los pacientes
Martinez, D., & Alonso, R. A. D. (2013) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/s1134-2072(13)70574-7
Home Blood Pressure Measurement - Epidemiology and Clinical Application
Niiranen, T. (2008) · STM:n Hallinnonalan avoin julkaisuarkisto (Julkari)
Neurogenic and Non-neurogenic Mechanisms of White-Coat Hypertension
Grassi, G. M., Seravalle, G., & Dell’Oro, R. (2014) · Springer eBooks · doi:10.1007/978-3-319-07410-8_3
An Increase in Blood Pressure Measured by a Physician and Change of Salivary Chromogranin A
Nakamura, S., Okubo, K., Takahashi, A., Nagao, K., Hirayama, A., & Kushiro, T. (2011) · Journal of Nihon University Medical Association · doi:10.4264/numa.70.179
Rogério, P., Hekman, W., Barbisan, J. N., Menezes, H. S., & Antonello, V. S. (2010)
[Home blood pressure measurement].
Niiranen, T., & Jula, A. (2009) · PubMed
Lloret, R. R., Murakami, D. Y., & França, H. H. (2010)
Control percibido y reactividad de la presión intraocular
Ulrich, M., & Luís, J. (2013) · TDX (Tesis Doctorals en Xarxa)
Essential Hypertension in Children: New Mechanistic Insights
Samuelsson, A. (2016) · InTech eBooks · doi:10.5772/62652 · Cited by 1
Prevalência de Hipertensão do Avental Branco na Atenção Primária
Marchi-Alves, L. M., Nogueira, M. S., de Godoy, S., Hayashida, M., & Cárnio, E. C. (2007)
The role of beta-blockers in the treatment of hypertension in 2018 ESC/ESH guidelines
Конради, А. О., Ратова, Л. Г., Emelyanov, I. V., & Недошивин, А. О. (2018) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2018-11-96-99
The Role of the Brain in Neurogenic Prehypertension
Seravalle, G., Hering, D., Grassi, G. M., & Narkiewicz, K. (2018) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-319-75310-2_25
Renal sympathetic denervation: renal nerve stimulation
de Jong, M. (2019) · doi:10.33612/diss.99857558
White Coat Hypertension—A Case for Assessing Vascular Age?
Climie, R. E., Lambert, É., Schlaich, M. P., & Lambert, G. W. (2020) · American Journal of Hypertension · doi:10.1093/ajh/hpaa061
Barrett, O., & Wolak, T. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-88369-6.00025-6
Clinical characterization of blood pressure phenotypes: the BP phenotype score
Al‐Mohaissen, M. A., Zohaifi, M. A. A., Lee, T., Almalki, N. A., Aleiban, H., & Al-Mehisen, R. (2025) · Blood Pressure · doi:10.1080/08037051.2025.2486284
Nsanya, M. K., Willkens, M. A., Ayieko, P., Reif, L. K., Nyanza, E. C., Kapiga, S., & Peck, R. N. (2026) · International Journal of Hypertension · doi:10.1155/ijhy/9797898
Salman, S., Navarro, G., & Elsaafien, K. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1848764
Konstantinidis, D., Kyriakoulis, K. G., Papadopoulos, G., Vakka, A., Papadomarkaki, K., Iliakis, P., Dimitriadis, K. P., & Tsioufis, K. P. (2026) · Hypertension Research · doi:10.1038/s41440-026-02711-8
Metadata
- Authors
- Smith, P. A., Graham, L. N., Mackintosh, A. F., Stoker, J. B., & Mary, D. A. S. G.
- Affiliations
- Leeds Teaching Hospitals NHS Trust (GB)
- Corresponding author
- Smith, Paul A
- ORCID
- Mackintosh, Alan F
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 40
- Issue
- 1
- Pages
- 126-132
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2052747904
- Cited by
- 146
- References
- 49
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 8 · 2022: 6 · 2021: 2 · 2020: 7 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 3 · 2015: 7 · 2014: 9 · 2013: 12 · 2012: 4
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- white coat hypertension, sympathetic hyperactivity, muscle sympathetic nerve activity, essential hypertension, baroreflex sensitivity, target organ damage, ambulatory blood pressure
- MeSH terms
- Adult, Blood Pressure, Female, Humans, Hypertension, Male, Middle Aged, Muscles, Pressoreceptors, Stress, Psychological, Sympathetic Nervous System, Vasoconstriction, Case-Control Studies
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