Treatment of white coat hypertension

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Medicine

Background:

• White coat hypertension (WCH) is defined as elevated blood pressure exclusively in a clinical environment, with normal readings during daily life.
• Its prevalence ranges from 20% to 45%, disproportionately affecting women, older individuals, and those with mild hypertension.
• WCH is distinct from the 'white coat effect,' which is the blood pressure difference between clinical and ambulatory readings.

Purpose of the Study:

• To define white coat hypertension and differentiate it from the white coat effect.
• To outline the prevalence and demographic associations of WCH.
• To establish appropriate management strategies for WCH.

Main Methods:

• Definition of WCH based on clinic vs. ambulatory blood pressure measurements.
• Analysis of prevalence data and associated patient characteristics.
• Review of clinical outcomes and recommended treatment protocols.

Main Results:

• WCH is identified by elevated clinic blood pressure and normal ambulatory blood pressure (daytime cutoff: 135/85 mm Hg).
• The condition is common, particularly in specific demographic groups.
• WCH is a benign condition with no significant increase in target-organ damage or cardiovascular mortality compared to normotensive individuals.

Conclusions:

• Pharmacological treatment for WCH is not recommended.
• Management should prioritize lifestyle modifications, including diet, exercise, weight management, and smoking cessation.
• Regular follow-up with ambulatory blood pressure monitoring (semiannual or annual) is advised.