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White-coat hypertension in adults

Fabio Angeli1, Paolo Verdecchia, Roberto Gattobigio

  • 1Department of Cardiovascular Disease, Hospital R. Silvestrini, Perugia, Italy.

Blood Pressure Monitoring
|February 24, 2006
PubMed

Insights

White-coat hypertension, high blood pressure only at the doctor's office, may increase long-term stroke risk. Further research is needed to confirm this and compare treatment strategies.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • White-coat hypertension (WCH) is characterized by elevated office blood pressure (BP) with normal readings outside the clinic.
  • The long-term prognostic significance of WCH remains debated, with varying reports on cardiovascular risks compared to sustained hypertension and normotension.

Purpose of the Study:

  • To investigate the long-term prognostic impact of white-coat hypertension on stroke incidence.
  • To explore potential differences in stroke risk between WCH and sustained ambulatory hypertension.
  • To identify the need for further studies on WCH management and long-term outcomes.

Main Methods:

  • Analysis of individual data from four large prospective cohort studies.
  • Longitudinal follow-up to assess the incidence of stroke in different BP categories.
  • Comparative analysis of hazard curves for stroke between white-coat hypertension and ambulatory hypertension groups.

Main Results:

  • The incidence of stroke showed a tendency to increase in the white-coat hypertension group over the long term.
  • The stroke hazard curve for WCH eventually crossed that of sustained ambulatory hypertension around the ninth year of follow-up.
  • These findings suggest WCH may not be entirely benign regarding long-term stroke risk.

Conclusions:

  • White-coat hypertension may pose a significant long-term risk for stroke, challenging its previously assumed benign nature.
  • Further research is crucial to validate the long-term stroke risk associated with WCH.
  • Comparative studies on treatment strategies, including lifestyle modifications versus drug therapy, are warranted for patients with WCH.

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