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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
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Is white-coat hypertension a risk factor for carotid atherosclerosis? A review and meta-analysis

Cesare Cuspidi1, Carla Sala, Marijana Tadic

  • 1aDepartment of Health Science, University of Milano-Bicocca bResearch Institute Auxologico cDepartment of Clinical Sciences and Community Health, University of Milan and Policlinico Hospital Foundation dResearch Institute Multimedica, Sesto San Giovanni, Milan, Italy eUniversity Clinical Hospital Centre 'Dragisa Misovic', Belgrade, Serbia.

Blood Pressure Monitoring
|November 19, 2014
PubMed

Insights

White-coat hypertension (WCH) is linked to increased carotid intima-media thickness (IMT), a marker of vascular damage. This study found WCH patients have greater IMT than normotensive individuals, suggesting WCH is not benign.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • The link between white-coat hypertension (WCH) and target organ damage, particularly subclinical vascular damage, remains controversial.
  • Existing research presents conflicting evidence regarding carotid structural changes in individuals with WCH.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis to investigate carotid structural changes in patients with WCH.
  • To provide updated evidence on the relationship between WCH and carotid intima-media thickness (IMT).

Main Methods:

  • Systematic review and meta-analysis of studies published in English over the last two decades.
  • Inclusion of studies reporting on carotid artery parameters in adults with normotension, WCH, and sustained hypertension.
  • Analysis of common carotid intima-media thickness (IMT) from 10 studies involving 3478 untreated patients.

Main Results:

  • Common carotid IMT showed a significant progressive increase from normotensive (718±36 μm) to WCH (763±47 μm) and to hypertensive patients (817±47 μm).
  • The difference in IMT between normotensive and WCH patients remained statistically significant after assessing publication bias.
  • Carotid IMT in WCH patients was not significantly different from that in sustained hypertensive patients.

Conclusions:

  • White-coat hypertension is associated with increased common carotid intima-media thickness compared to true normotension.
  • The vascular damage indicated by carotid IMT in WCH patients is comparable to that observed in sustained hypertensive individuals.
  • These findings suggest that white-coat hypertension is not a benign condition and may warrant closer monitoring for vascular complications.

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