Cardiac end-organ changes: comparison between white coat hypertension and persistent mild hypertension

Conflicting viewpoints exist concerning the risk of cardiovascular morbidity for patients with white coat hypertension. The aim of this study was to compare cardiac end-organ change in white coat hypertension with persistent mildly hypertensive patients. Twenty-two white coat hypertensive patients and 15 persistently hypertensive patients were considered eligible for the study after 24 hour ambulatory blood pressure monitoring. Echocardiography was performed on all patients. The results demonstrated that both groups had similar clinical backgrounds except that white coat hypertensives were predominantly female and had less family history of hypertension. Persistent hypertensives had significantly higher average ambulatory blood pressures and pressure loads than white coat hypertensives but there was no difference in blood pressure variability. There were no differences in cardiac structural and functional changes between the two groups. As a result, we were unable to ascertain whether white coat hypertension is a benign condition. The prognostic significance of white coat hypertension requires long term follow-up and further investigation.