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Untreated White Coat HTN May Increase Cardiovascular Risk

Treated white coat effect not tied to cardiovascular events or all-cause, cardiovascular mortality

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MONDAY, June 10, 2019 (HealthDay News) -- The risk for cardiovascular events and all-cause mortality is increased for individuals with untreated white coat hypertension (WCH) but not for those with treated white coat effect (WCE), according to a review published online June 11 in the Annals of Internal Medicine.

Jordana B. Cohen, M.D., from the University of Pennsylvania in Philadelphia, and colleagues summarized the risk for cardiovascular events and all-cause mortality using data from 27 studies, with 25,786 participants with untreated WCH or treated WCE and 38,487 with normal blood pressure (BP) followed for a mean of three to 19 years.

The researchers found that untreated WCH correlated with an increased risk for cardiovascular events, all-cause mortality, and cardiovascular mortality compared with normotension (hazard ratios, 1.36 [95 percent confidence interval, 1.03 to 2.00], 1.33 [95 percent confidence interval, 1.07 to 1.67], and 2.09 [95 percent confidence interval, 1.23 to 4.48], respectively); in studies that included stroke in the definition of cardiovascular events, the risk for WCH was attenuated (hazard ratio, 1.26; 95 percent confidence interval, 1.00 to 1.54). Treated WCE was not significantly associated with cardiovascular events (hazard ratio, 1.12; 95 percent confidence interval, 0.91 to 1.39), all-cause mortality (hazard ratio, 1.11; 95 percent confidence interval, 0.89 to 1.46), or cardiovascular mortality (hazard ratio, 1.04; 95 percent confidence interval, 0.65 to 1.66).

"This systematic review and meta-analysis highlights the importance of future trials to evaluate interventions to reduce cardiovascular risk in WCH," the authors write.

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