White Coat Hypertension Is Not Benign and Should Not Be Ignored

Dr. Wanpen Vongpatanasin MD Program Director, Hypertension Fellowship Program Professor of Internal Medicine Director of the University of Texas Southwestern Hypertension ProgramMedicalResearch.com Interview with:
Dr. Wanpen Vongpatanasin MD
Program Director, Hypertension Fellowship Program
Professor of Internal Medicine
Director of the University of Texas Southwestern Hypertension Program

Medical Research: What is the background for this study? What are the main findings?

Dr. Vongpatanasin: Home blood pressure measurement may reveal very different number when compared to clinic blood pressure in hypertensive patients.  This difference can manifest as white coat hypertension (White Coat Hypertension; elevated office blood pressure with normal ambulatory or home blood pressure), or masked hypertension (MH; elevated ambulatory or home BP with normal office blood pressure).  Although numerous epidemiological studies from Europe and Asia have shown increased cardiovascular risks associated with White Coat Hypertension and masked hypertension, previous studies have not addressed cardiovascular outcomes associated with White Coat Hypertension and masked hypertension in the general population in the United States.

We found that  participants in the Dallas Heart Study, a multiethnic populational-based study in the Dallas County, both White Coat Hypertension and MH are associated with increased aortic stiffness and markers of kidney damage when compared to the group with normal blood pressure both at home and in the clinic. Furthermore, both white coat hypertension and masked hypertension are associated with increased risk of cardiovascular events, including coronary heart disease, stroke, atrial fibrillation, heart failure, and cardiovascular death over a median follow-up period of 9 years.

Medical Research: What should clinicians and patients take away from your report?

Dr. Vongpatanasin: Both White Coat Hypertension and masked hypertension are not benign finding and should not be ignored.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Vongpatanasin: Since masked hypertension is very common in our cohort (18%) and more common than both White Coat Hypertension (3%) and sustained hypertension (12%), home blood pressure monitoring should be routinely perform in patients with suspected or established hypertension.

Further studies are needed to determine if antihypertensive treatment of masked hypertension or White Coat Hypertension will reduce cardiovascular risk

Citation:

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Dr. Wanpen Vongpatanasin MD (2015). White Coat Hypertension Is Not Benign and Should Not Be Ignored 

Last Updated on November 11, 2015 by Marie Benz MD FAAD