Does White-Coat Hypertension Affect Patient Outcomes?

Research has yielded inconsistent results on whether white-coat hypertension (WCH) — elevated in-office blood pressure (BP) and normal out-of-office BP in patients naive to antihypertensive agents — is associated with different clinical outcomes than is normotension. In this meta-analysis of 27 observational studies that involved 65,000 patients, investigators compared normotensive patients, patients with WCH, and patients with “white-coat effect” (WCE; elevated in-office BP and controlled out-of-office BP in patients taking antihypertensive medication). WCH and WCE were confirmed by either ambulatory BP monitoring or home BP monitoring.

Compared with normotensive patients, patients with WCH had significant excess risk for adverse cardiovasc…