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Short- and long-term risk of cardiovascular events in white-coat hypertension

S D Pierdomenico1, D Lapenna, R Di Mascio

  • 1Department of Medicine and Aging Science, University Gabriele d'Annunzio, Chieti, Italy. pierdomenico@unich.it

Journal of Human Hypertension
|February 22, 2008
PubMed

Insights

White-coat hypertension poses a lower cardiovascular risk than sustained hypertension, similar to normotension. This study found no significant difference in cardiovascular events between white-coat hypertension and normal blood pressure over the long term.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Outcomes

Background:

  • The prognostic significance of white-coat hypertension (WCH) remains uncertain.
  • Distinguishing WCH from sustained hypertension (SH) is crucial for accurate cardiovascular risk assessment.

Purpose of the Study:

  • To compare cardiovascular outcomes in patients with sustained hypertension, white-coat hypertension, and normotension.
  • To evaluate the short-term and long-term prognostic impact of WCH.

Main Methods:

  • A cohort study involving 1732 patients with clinical hypertension (1333 SH, 399 WCH) and 305 normotensive individuals.
  • WCH defined as clinical hypertension with daytime blood pressure <135/85 mm Hg.
  • Follow-up for a mean of 6.4 years to track fatal and nonfatal cardiovascular events.

Main Results:

  • The event rate per 100 patient-years was 0.38 for normotension, 0.44 for WCH, and 1.58 for SH.
  • Cox regression analysis revealed significantly higher cardiovascular risk in SH compared to WCH (RR 3.32).
  • No significant difference in cardiovascular risk was observed between WCH and normotension.

Conclusions:

  • Cardiovascular risk in white-coat hypertension is significantly lower than in sustained hypertension.
  • White-coat hypertension does not confer a significantly different cardiovascular risk compared to normotension.
  • These findings support that WCH may not require the same level of intervention as sustained hypertension.

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