Key result
Antihypertensive drug therapy did not reduce the risk of cardiovascular events in patients with white coat hypertension compared to no treatment, despite the presence of cardiovascular structural alterations.
Why the study?
Evidence suggests white coat hypertension is not entirely benign, but whether affected patients should receive antihypertensive drug therapy remains unresolved.
Does white coat hypertension alter cardiovascular structure compared to normotension and sustained hypertension, and does antihypertensive therapy reduce cardiovascular events in patients with white coat hypertension?
Meta-Analysis (n=8,100)
Does white coat hypertension alter cardiovascular structure compared to normotension and sustained hypertension, and does antihypertensive therapy reduce cardiovascular events in patients with white coat hypertension?
White coat hypertension is associated with intermediate cardiovascular structural alterations between normotension and sustained hypertension, but antihypertensive therapy does not appear to reduce cardiovascular events in these patients.
Antihypertensive therapy confers no cardiovascular event reduction in white coat hypertension; challenges treatment based on structural alterations alone.
A large and growing body of literature has focused on the association between "white coat hypertension" (WCH) and the underlying target organ damage. The evidence suggests that WCH is may not an entirely benign phenomenon. However, whether patients with WCH should receive antihypertensive drugs is unresolved. Therefore, we performed a meta-analysis to fully determine the ability of WCH to alter cardiovascular structure and to determine whether patients with WCH could benefit from drug intervention. Medline, EMBASE, and the Cochrane Library were searched from inception through 21 Oct 2019. A total of 25 studies (8,100 individuals) were included. In participants with WCH, values of aortic pulse wave velocity, augmentation index, intima-media thickness, interventricular septum thickness, left ventricular posterior wall thickness, and left ventricular mass index were lower than those with sustained hypertension, but greater than those in the normotensive group. Of note, antihypertensive drug therapy did not reduce the risk of cardiovascular events in patients with WCH. WCH is accompanied by alterations of cardiovascular structure; however, the benefits from antihypertensive therapy are limited.
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Xiang et al. (2020) conducted a meta-analysis in White Coat Hypertension (n=8,100). Antihypertensive drug therapy vs. No treatment was evaluated on Cardiovascular events. Antihypertensive drug therapy did not reduce the risk of cardiovascular events in patients with white coat hypertension compared to no treatment, despite the presence of cardiovascular structural alterations.
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