Untreated white coat hypertension is associated with increased cardiovascular risk, but white coat effect in those taking antihypertensives is not, according to a meta-analysis in the Annals of Internal Medicine.
Researchers analyzed 27 observational studies involving over 64,000 people with both in- and out-of-office blood pressure monitoring. White coat hypertension referred to elevated in-office but normal out-of-office BP readings in those not receiving antihypertensive treatment. White coat effect referred to elevated in-office but normal out-of-office BP readings in those receiving antihypertensives.
White coat hypertension was associated with a 36% higher risk for cardiovascular events and 33% higher risk for mortality, compared with normotension. However, risks were still lower than those observed in patients with sustained hypertension. White coat effect was not associated with increased risk for either outcome.
Editorialists note that the increased CV risk with white coat hypertension might apply only to high-risk older adults. Nonetheless, they conclude that the meta-analysis “makes an important contribution and provides contemporary data supporting recent U.S. and European guidelines that recommend out-of-office BP monitoring.”
Read the article here.
Source: NEJM Journal Watch