White coat hypertension and white coat effect. Similarities and differences

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Medicine

Background:

• The white coat effect, a rise in blood pressure during clinical visits, is a potential mechanism for white coat hypertension.
• Previous studies have not extensively assessed the relationship between white coat hypertension, the white coat effect, and target organ damage in large populations.

Purpose of the Study:

• To investigate the prevalence of white coat hypertension.
• To assess the association between white coat hypertension, the white coat effect, and target organ damage (left ventricular mass).
• To examine the relationship between white coat hypertension and hypertension severity (JNC V stages).

Main Methods:

• 24-hour noninvasive ambulatory blood pressure monitoring was conducted.
• 2D-guided M-mode echocardiography was used to assess left ventricular mass.
• 1,333 untreated essential hypertension patients and 178 normotensive controls were studied.

Main Results:

• White coat hypertension was identified in 18.9% of subjects (252/1333).
• Left ventricular mass was not significantly greater in the white coat hypertension group compared to normotensive controls.
• Left ventricular mass was significantly increased in the ambulatory hypertension group.
• The prevalence of white coat hypertension decreased significantly with increasing hypertension severity (JNC V stages).

Conclusions:

• White coat hypertension, while common, did not appear to be associated with increased left ventricular mass in this cohort.
• Ambulatory hypertension, however, was linked to increased left ventricular mass.
• Hypertension severity is inversely correlated with the prevalence of white coat hypertension.