White-coat hypertension was associated with higher cardiovascular morbidity and mortality compared with normotension, but risks were significantly lower than those associated with sustained hypertension.
Systematic Review (n=29,100)
Does white-coat hypertension increase the risk of cardiovascular events and mortality compared with normotension and sustained hypertension?
White-coat hypertension is associated with a slightly higher risk of cardiovascular morbidity and mortality compared to normotension, but a significantly lower risk compared to sustained hypertension.
BACKGROUND: White-coat hypertension (WCH) is a frequent condition particularly in children and elderly individuals. The prognostic significance of WCH is still a matter of debate. METHODS: The present study was designed to systematically review cohort studies and assess the effects of WCH compared with normotension and sustained HTN on cardiovascular events and death, stroke, and all-cause mortality. We systematically searched the electronic databases, MEDLINE, PUBMED, EMBASE, and Cochrane for prospective cohort studies, which evaluated participants with office, and ambulatory, and/or home blood pressure. RESULTS: We included 14 studies with a total number of 29 100 participants (13 538 normotensive patients, 4806 with WCH and 10 756 with sustained HTN) with mean age of 59 years and follow-up of 8 years. Individuals with WCH had higher rates of cardiovascular disease morbidity and mortality but not significantly different all-cause mortality and stroke risk compared with normotensive patients. Cardiovascular disease morbidity and mortality, all-cause mortality, and stroke rates were significantly increased in patients with sustained HTN compared with WCH. CONCLUSION: The cardiovascular morbidity and mortality associated with WCH may be slightly higher compared with normotension but well below the risks associated with sustained HTN.
Briasoulis et al. (Wed,) conducted a systematic review in White-coat hypertension (n=29,100). White-coat hypertension vs. Normotension and sustained hypertension was evaluated on Cardiovascular events and death, stroke, and all-cause mortality. White-coat hypertension was associated with higher cardiovascular morbidity and mortality compared with normotension, but risks were significantly lower than those associated with sustained hypertension.