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Diagnosis and management of patients with white-coat and masked hypertension

Giuseppe Mancia1, Michele Bombelli, Gino Seravalle

  • 1Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Via Pergolesi 33, 20052 Monza, Italy. giuseppe.mancia@ unimib.it

Nature Reviews. Cardiology
|August 10, 2011
PubMed

Insights

White-coat hypertension (high clinic blood pressure) and masked hypertension (normal clinic blood pressure) require careful diagnosis. Both conditions are linked to increased cardiovascular and metabolic risks, necessitating lifestyle changes or medication.

Area of Science:

  • Cardiology
  • Hypertension Management

Background:

  • White-coat hypertension (WCH) involves elevated clinic blood pressure with normal out-of-office readings.
  • Masked hypertension (MH) presents with normal clinic blood pressure but elevated out-of-office readings.
  • Both WCH and MH are common and require accurate diagnosis and monitoring.

Purpose of the Study:

  • To highlight the clinical significance of WCH and MH.
  • To emphasize the association of WCH and MH with cardiovascular and metabolic risks.
  • To guide diagnostic and therapeutic approaches for WCH and MH.

Main Methods:

  • The study reviews the definitions and clinical implications of WCH and MH.
  • It discusses the diagnostic evaluation, including ambulatory blood pressure monitoring.
  • It outlines therapeutic strategies based on risk assessment.

Main Results:

  • WCH and MH are associated with increased cardiovascular risk and organ damage, though not always.
  • Patients with WCH or MH have a higher risk of glucose and lipid profile abnormalities.
  • Accurate diagnosis is crucial for assessing overall cardiovascular and metabolic risk.

Conclusions:

  • Diagnosis of WCH and MH necessitates comprehensive cardiovascular and metabolic risk assessment.
  • First-line treatment involves non-pharmacological lifestyle modifications.
  • Pharmacological treatment is considered for elevated cardiovascular risk or target-organ damage.

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