Complications of white-coat hypertension compared to a normotensive and hypertensive population

• Main Authors: Ziad Abdullah Taher, Waleed W Khayyat, Marwan M Balubaid, Mohamed Y Tashkandi, Saeed M Alamoudi, Abdulhalim Jamal Kinsara
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Heart Views
• Subjects: ambulatory blood pressure monitoring; blood pressure variability; cardiac complications; white-coat hypertension
• Online Access: http://www.heartviews.org/article.asp?issn=1995-705X;year=2021;volume=22;issue=1;spage=8;epage=12;aulast=Taher

Background: Accumulating evidence demonstrates that white-coat hypertension (WCH) are associated with several risks and complications. In this study, we aimed to investigate the adverse effects of WCH compared with hypertensive and normotensive patients. Methods: A retrospective cohort study was conducted over five years. Blood pressure (BP) data was collected from both clinic visits and 24-h ambulatory blood pressure monitoring (ABPM) reports. Epidemiological data and complications, cardiac and noncardiac, were also recorded. Results: In total, 286 participants who were followed up for at least three years were included. The sample was divided into 99 normotensive patients (as a control group), 94 patients with clinically diagnosed hypertension (HTN), and 93 patients with WCH. Ischemic heart disease (IHD) was the most noted complication in the WCH group with a relative risk of 9.58 (1.23–74.16) (P = 0.008). Acute coronary syndrome (ACS) was significantly correlated with a relative risk of 2.06 (0.52–13.38). No significant correlation was noted with noncardiac complications. Both HTN and WCH groups showed a significant association with blood pressure variability (BPV). WCH was associated with an increased BPV in ambulatory daytime systolic measurements (P = 0.031) and a unique increase in diastolic measurement variability in office BP measurements (P = 0.020). Conclusion: WCH should be managed as HTN. WCH is associated with cardiac complications, particularly IHD, specifically in patients 55 years and older. WCH was significantly associated with a higher BPV in both ABPM and office-based measurements.