White coat effect in treated hypertensive patients: sex differences

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Trials

Background:

• The white coat effect, characterized by elevated office blood pressure (BP) compared to ambulatory BP, is a recognized phenomenon in hypertensive patients.
• Understanding factors influencing the white coat effect is crucial for accurate diagnosis and treatment of hypertension.

Purpose of the Study:

• To determine the prevalence of the white coat effect in patients undergoing anti-hypertensive therapy.
• To evaluate the influence of patient sex on the occurrence and severity of the white coat effect.

Main Methods:

• Ambulatory blood pressure monitoring was conducted in 152 patients receiving anti-hypertensive treatment.
• The white coat effect was defined as an office-ambulatory BP difference of ≥20/10 mm Hg, with severe white coat effect defined as ≥40/20 mm Hg.

Main Results:

• A white coat effect was observed in 106 (69.7%) of patients, and a severe white coat effect in 49 (32.2%).
• The white coat effect was significantly more prevalent in women (70/87) than in men (36/65) (P < 0.001).
• Female sex and higher office systolic BP were significantly correlated with the presence of a white coat or severe white coat effect (P < 0.001).

Conclusions:

• Female patients with treated hypertension exhibit a higher likelihood of experiencing a white coat effect compared to male patients.
• These observed sex differences in the white coat effect should be considered in future research and clinical evaluations of hypertension.
• Accurate assessment of blood pressure, considering the white coat phenomenon, is essential for effective hypertension management.