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White-coat hypertension and cardiovascular events: a meta-analysis

Alexandros Briasoulis1, Emmanuel Androulakis, Mohan Palla

  • 1aDivision of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Michigan, USA bJohn Radcliffe Hospital, University of Oxford, Oxford cBarts Heart Centre, St Bartholomew's Hospital, London, UK dDepartment of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.

Journal of Hypertension
|January 7, 2016
PubMed

Insights

White-coat hypertension (WCH) increases cardiovascular risks compared to normal blood pressure. However, sustained hypertension poses significantly higher risks for cardiovascular events and mortality.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Epidemiology

Background:

  • White-coat hypertension (WCH) is prevalent in pediatric and geriatric populations.
  • The long-term prognostic implications of WCH remain under investigation.

Purpose of the Study:

  • To systematically review cohort studies on WCH.
  • To compare cardiovascular outcomes, stroke, and mortality in WCH versus normotension and sustained hypertension.

Main Methods:

  • Systematic search of MEDLINE, PUBMED, EMBASE, and Cochrane databases.
  • Inclusion of prospective cohort studies assessing office, ambulatory, and/or home blood pressure.
  • Analysis of 14 studies with 29,100 participants (mean age 59, follow-up 8 years).

Main Results:

  • WCH patients showed increased cardiovascular morbidity and mortality versus normotensive individuals.
  • No significant difference in all-cause mortality or stroke risk between WCH and normotensive groups.
  • Sustained hypertension significantly elevated cardiovascular disease, mortality, and stroke risks compared to WCH.

Conclusions:

  • Cardiovascular risks associated with WCH are slightly elevated compared to normotension.
  • Risks for WCH are substantially lower than those observed in sustained hypertension.
Abstract

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