January 25, 2004American Journal of Hypertension
White coat effect in treated versus untreated hypertensive individuals: a case-control study using ambulatory and home blood pressure monitoring
Key result
Antihypertensive treatment was associated with a non-significant trend toward fewer clinic reactors compared to untreated hypertension (20% vs 27%; OR 1.5, 95% CI 0.9-2.7).
Why the study?
Does antihypertensive treatment reduce the magnitude and prevalence of the white coat effect compared to untreated hypertensive individuals?
Population
276 hypertensive individuals (138 treated patients and 138 sex- and age-matched untreated subjects)
Comparison
Antihypertensive treatment vs No antihypertensive treatment (untreated)
Design
Case-control
Authors
Discussion
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Implication
Antihypertensive treatment may modestly attenuate clinic reactivity; leaves open whether this meaningfully reduces white coat effect prevalence.
Study Design
Type
Case-Control (n=276)
Structured PICO
Does antihypertensive treatment reduce the magnitude and prevalence of the white coat effect compared to untreated hypertensive individuals?
P
Population
276 hypertensive individuals (138 treated patients and 138 sex- and age-matched untreated subjects)
I
Intervention
Antihypertensive treatment
C
Comparator
No antihypertensive treatment (untreated)
O
Outcome
Prevalence and magnitude of the white coat effect (WCE) and usefulness of home blood pressure (HBP) versus ambulatory blood pressure (ABP) in detecting WCEsurrogate
Main Result
Effect estimate: OR 1.5 (95% CI 0.9 to 2.7)
Absolute Event Rate: 20% vs 27%
The white coat effect is reduced but not eliminated in treated hypertensive patients compared to untreated individuals, and home BP monitoring is useful but not a complete alternative to ambulatory BP monitoring for detecting it.
Cite This Study
George S. Stergiou (2004) conducted a case-control in Hypertension (n=276). Antihypertensive treatment vs. No antihypertensive treatment was evaluated on Clinic reactors (white coat effect >20/10 mm Hg) (OR 1.5, 95% CI 0.9 to 2.7). Antihypertensive treatment was associated with a non-significant trend toward fewer clinic reactors compared to untreated hypertension (20% vs 27%; OR 1.5, 95% CI 0.9-2.7).