White-Coat Hypertension: Pathophysiological and Clinical Aspects: Excellence Award for Hypertension Research 2020

Area of Science:

• Cardiovascular Medicine
• Hypertension Research
• Clinical Epidemiology

Background:

• White-coat hypertension (WCH) is defined by elevated office blood pressure with normal out-of-office readings.
• Historically, WCH was considered benign, but recent evidence suggests an associated cardiovascular risk.
• Understanding WCH is crucial for accurate cardiovascular risk assessment and management.

Purpose of the Study:

• To review the definition, pathophysiology, clinical alterations, and prognostic significance of white-coat hypertension.
• To synthesize evidence from recent decades, including data from the PAMELA study.
• To discuss therapeutic implications and unresolved issues in WCH research.

Main Methods:

• Comprehensive literature review of studies on white-coat hypertension over the past decades.
• Analysis of data from the PAMELA (Pressioni Arteriose Monitorate e Loro Associazioni) research project.
• Cross-sectional and longitudinal study designs were considered.

Main Results:

• Recent studies indicate that WCH is associated with an increased cardiovascular risk, contrary to earlier findings.
• The PAMELA project provided novel clinical insights into the characteristics and prognosis of WCH.
• An elevated cardiovascular risk appears to be a trait of the WCH phenotype.

Conclusions:

• White-coat hypertension is not a benign condition and carries significant prognostic implications.
• Further research is needed to clarify controversial aspects and guide therapeutic strategies for WCH.
• Accurate diagnosis and risk stratification are essential for patients with WCH.