White Coat Hypertension and Cardiovascular Diseases: Innocent or Guilty
Purpose of Review
This review aims to clarify the cardiovascular risk of white coat hypertension (WCH).
Cardiovascular risk of WCH has been evaluated in multiple meta-analyses and population-based studies. International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes study evaluated the cardiovascular risk in 653 patients with WCH and 5137 normotensive patients. The patients were age-matched and were followed for 10.6 years. The results revealed no increased cardiovascular risk except in older high-risk WCH patients. A recent meta-analysis evaluated the cardiovascular risk in WCH subjects without any antihypertensive treatment (23 cohorts, 20 445 individuals), WCH subjects with antihypertensive treatment (11 cohorts, 8656 individuals), and mixed population including both treated and untreated subjects (12 cohorts, 21 336 individuals). This study revealed increased cardiovascular risk in untreated and mixed population WCH subjects but not in treated WCH subjects.
WCH might have prognostic impact on cardiovascular outcomes; however, this is not true in all WCH subjects. Further studies should identify the subgroups of WCH that are at increased risk and evaluate the effect of therapeutic measures on cardiovascular outcomes.
KeywordsWhite coat hypertension Cardiovascular disease Cardiovascular mortality Ambulatory blood pressure monitoring
Compliance with Ethical Standards
Conflict of Interest
Mehran Abolbashari declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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