White Coat Hypertension Risky

A systematic review and meta-analysis suggested that untreated white coat hypertension (WCH, isolated elevated office blood pressure [BP]), but not treated white coat effect (WCE, treated WCH), is associated with an increased risk for cardiovascular events and all-cause mortality. The analysis included 27 observational studies, comprising 25 786 participants with untreated WCH or treated WCE and 38 487 with normal BP followed for a mean of 3 to 19 years. Compared with normotension, untreated WCH was associated with an increased risk for cardiovascular events (hazard ratio [HR], 1.36), all-cause mortality (HR, 1.33), and cardiovascular mortality (HR, 2.09); the risk of WCH was attenuated in studies that included stroke in the definition of cardiovascular events (HR, 1.26). No significant increased risk was found with treated WCE. The findings persisted across several sensitivity analyses although are not consistent with several early studies. The analysis supports guidelines recommending out-of-office BP monitoring. Source: https://annals.org/