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[Prognostic importance of white coat and masked hypertension]
Pia Gustavsen1, Tine Willum Hansen
1Kardiologisk Afdeling P, Gentofte Hospital, DK-2900 Hellerup. gustavsen@dadlnet.dk
Insights
White coat hypertension (WCH) has low cardiovascular risk, while masked hypertension (MH) increases risks. Both WCH and MH, along with sustained hypertension, show a gradual increase in cardiovascular risk.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Diagnostics
Context:
- Ambulatory blood pressure monitoring (ABPM) is increasingly utilized.
- Discrepancies between office and ambulatory blood pressure measurements are recognized.
- Two key discrepancies are white coat hypertension (WCH) and masked hypertension (MH).
Purpose:
- To differentiate the cardiovascular risk associated with WCH and MH.
- To understand the risk spectrum from normotension to sustained hypertension.
Summary:
- White coat hypertension (WCH) is generally associated with lower cardiovascular risk.
- Masked hypertension (MH) is linked to significantly increased cardiovascular morbidity and mortality.
- Longitudinal studies indicate a progressive increase in cardiovascular risk from normotension through WCH and MH to sustained hypertension.
Impact:
- Highlights the clinical significance of differentiating WCH and MH.
- Informs risk stratification and management strategies for hypertensive patients.
- Emphasizes the importance of ABPM in cardiovascular risk assessment.
Abstract:
The growing use of ambulatory blood pressure monitoring has led to an increased awareness of the two types of discrepancy between office blood pressure and ambulatory blood pressure, called white coat hypertension (WCH) and masked hypertension (MH). Based on several longitudinal studies, WCH is viewed as a condition with a relatively low cardiovascular risk, whereas patients with MH have an increased risk of cardiovascular morbidity and mortality. Two studies documented a gradually increased risk from normotension over WCH and MH to sustained hypertension.
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