The long-term reproducibility of the white-coat effect on blood pressure as a continuous variable from the Ohasama...

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Epidemiology

Background:

• The reproducibility of the white coat effect (WCE) as a continuous variable over the long term is not well-established.
• Understanding WCE reproducibility is crucial for accurate hypertension diagnosis and management.

Purpose of the Study:

• To investigate the long-term reproducibility of the white coat effect as a continuous variable.
• To assess the stability of WCE over a 4-year interval in a general population sample.

Main Methods:

• A cohort of 153 participants without antihypertensive treatment from Ohasama, Japan, was studied over 4 years.
• White coat effect was repeatedly measured as the difference between office and home blood pressure.
• Reproducibility was assessed using the intraclass correlation coefficient and Bland-Altman analysis.

Main Results:

• The white coat effect for systolic and diastolic blood pressure showed a slight average decrease of 0.17/1.56 mmHg over 4 years.
• Bland-Altman plots indicated no significant systemic error in WCE measurements (P ≥ 0.24).
• Intraclass correlation coefficients for WCE, office BP, and home BP were 0.41, 0.64, and 0.74, respectively, suggesting limited reproducibility of WCE.

Conclusions:

• Long-term reproducibility of the white coat effect is limited in the general population not receiving antihypertensive treatment.
• Variations in office blood pressure are the primary drivers of changes in the white coat effect over time.