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Current status of white coat hypertension: where are we?
Gani Nuredini1, Alec Saunders1, Chakravarthi Rajkumar1,2
1Department of Medicine, Brighton and Sussex Medical School, Brighton, UK.
Insights
White coat hypertension (WCH), an elevated clinic blood pressure with normal home readings, is linked to cardiovascular risks. More research is needed to confirm its impact on outcomes and guide treatment decisions.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Medicine
Background:
- White coat hypertension (WCH) is defined by elevated clinic blood pressure (BP) but normal readings outside the clinic.
- It affects about one-third of untreated individuals with elevated clinic BP.
- WCH is associated with cardiovascular risk factors and target organ damage.
Purpose of the Study:
- To provide an updated understanding of white coat hypertension.
- To review WCH's clinical characteristics, cardiovascular risk associations, and treatment evidence.
- To identify gaps in current research on WCH.
Main Methods:
- This is a narrative review.
- The review synthesizes current evidence on WCH.
- Focus is on clinical implications, risk factors, and treatment.
Main Results:
- WCH is linked to increased cardiovascular risk factors.
- The association between WCH and cardiovascular outcomes is debated.
- Evidence from randomized controlled trials regarding WCH treatment is insufficient.
Conclusions:
- WCH is associated with cardiovascular risk factors.
- Further research is necessary to clarify the impact of WCH on cardiovascular outcomes.
- More robust evidence is needed to establish treatment guidelines for WCH.
Abstract:
White coat hypertension (WCH) is characterised by an elevated clinic blood pressure (BP) with normal ambulatory or home BP. It is well recognised in clinical practice and occurs in approximately one-third of untreated patients with elevated clinic BP. Current evidence suggests that WCH is associated with cardiovascular risk factors, including the development of sustained hypertension and the presence of target organ damage. However, its effects on cardiovascular outcomes remain a matter of debate. There is also insufficient evidence from randomised controlled trials to determine whether WCH warrants treatment. This narrative review aims to provide an update on the current understanding of WCH. It focuses on the clinical characteristics and potential implications of WCH, its relationship to cardiovascular risk and the evidence regarding treatment. Gaps in existing research are also highlighted.
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