Key result
White-coat hypertension is linked to ~2.5-fold higher risk of progression to sustained hypertension.
Why the study?
White-coat hypertension has long been regarded as a benign phenotype, and whether it genuinely progresses to sustained hypertension remains debated.
Meta-Analysis (n=8,297)
Yes
Answers are grounded in this paper and cite their sources.
May support closer surveillance of white-coat hypertension; extends meta-analysis of observational cohorts on progression risk.
Background: Office blood pressure (BP) can be influenced by an alerting reaction to the clinical setting, giving rise to white-coat hypertension (WCH), long regarded as a benign phenotype. Whether WCH genuinely progresses to sustained hypertension remains debated. This review aimed to determine the pooled risk of progression from WCH to sustained hypertension and to explore the influence of diagnostic method, follow-up duration, and population characteristics on this risk. Methods:Following PRISMA 2020 and Cochrane Handbook guidance, MEDLINE/PubMed, Web of Science, Scopus, CENTRAL, Science Direct, and ClinicalTrials.gov were searched from inception to 3 July 2026 for observational cohort studies classifying untreated participants as WCH or normotensive using paired office and out-of-office BP, with repeated assessment at follow-up. Risk of bias was assessed using the QUIPS tool.
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Alqarni et al. (2026) conducted a meta-analysis in White-coat hypertension (n=8,297). White-coat hypertension (elevated office BP with normal out-of-office BP) vs. Sustained normotension (normal office and out-of-office BP) was evaluated on Progression to sustained hypertension at follow-up (RR 2.52, 95% CI 1.93-3.29). White-coat hypertension significantly increased the risk of progression to sustained hypertension compared with normotension (pooled RR 2.52, 95% CI 1.93–3.29).
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