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White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study

P H Gustavsen1, A Høegholm, L E Bang

  • 1Department of Internal Medicine, County Central Hospital, Naestved, Denmark. gustavsen@dadlnet.dk

Journal of Human Hypertension
|January 6, 2004
PubMed

Insights

White coat hypertension (WCH) patients face increased cardiovascular risk, similar to established hypertension, over a 10-year period. This finding contrasts with the benign prognosis previously suggested for WCH.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • White coat hypertension (WCH) is characterized by elevated blood pressure (BP) in clinical settings but normal readings elsewhere.
  • The long-term prognosis of WCH remains uncertain, with some studies suggesting it is benign.

Purpose of the Study:

  • To evaluate the cardiovascular risk associated with white coat hypertension.
  • To compare the long-term outcomes of WCH patients with established hypertension and normotensive controls.

Main Methods:

  • A 10-year follow-up study involving 420 newly diagnosed hypertensive patients and 146 normotensive controls (NTs).
  • Ambulatory blood pressure (ABP) monitoring was used at baseline to identify WCH using a cutoff of daytime-ABP <135/90 mmHg.
  • Cardiovascular events, including deaths and nonfatal events, were recorded for all participants.

Main Results:

  • The study identified 76 WCH patients (18.1%) and 344 established hypertensive (EH) patients.
  • The WCH group experienced 18.4% first cardiovascular events, comparable to the EH group (16.3%) and significantly higher than the NT group (6.8%).
  • Even with a lower ABP cutoff (135/85 mmHg), WCH remained associated with a significantly higher cardiovascular event rate.

Conclusions:

  • White coat hypertension is associated with an increased cardiovascular risk compared to normotensive individuals.
  • The cardiovascular risk in WCH is comparable to that observed in established hypertension.
  • These findings challenge the notion that WCH is a benign condition.

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