Prevalence and management patterns of white-coat hypertension in Dubai

A BSTRACT Introduction: White-coat hypertension (WCH) is characterized by elevated blood pressure (BP) readings in clinical settings despite normal out-of-office measurements. Failure to identify WCH may result in misdiagnosis and unnecessary antihypertensive treatment. This study aimed to determine the prevalence of WCH and describe associated clinical characteristics and management patterns among adults attending a family medicine clinic in Dubai. Methods: A retrospective observational study was conducted at a family medicine clinic in a tertiary care hospital in Dubai. Medical records of adults aged ≥18 years with at least two elevated clinic BP readings (≥130/80 mmHg) or a recommendation for ambulatory BP monitoring (ABPM) or home BP monitoring (HBPM) were reviewed. Data on demographics, body mass index, comorbidities, lifestyle factors, BP measurements, and management strategies were collected and analyzed. Results: Among 100 patients, the prevalence of WCH was 29%. Median clinic BP readings were 144/90 mmHg initially and 141/85 mmHg on repeat assessment. Most participants were male (67%), middle-aged, and overweight or obese (80%). Comorbidities were present in 81% of patients. ABPM or HBPM was performed in 98% of cases. No significant associations were identified between WCH and demographic or clinical characteristics. Lifestyle counseling was the most common management strategy (68.9%), whereas antihypertensive therapy was prescribed in only 6.9% of patients with WCH. Conclusion: Nearly one-third of patients had WCH. These findings highlight the importance of ABPM and HBPM for accurate diagnosis and avoidance of unnecessary treatment. Lifestyle modification remains the primary management approach, and larger multicenter studies are needed to inform regional hypertension care.