scholarly journals White-Coat Hypertension: Pathophysiological and Clinical Aspects: Excellence Award for Hypertension Research 2020

Hypertension ◽  
2021 ◽  
Vol 78 (6) ◽  
pp. 1677-1688
Author(s):  
Giuseppe Mancia ◽  
Rita Facchetti ◽  
Michele Bombelli ◽  
Cesare Cuspidi ◽  
Guido Grassi
Keyword(s):  
Blood Pressure ◽  
Longitudinal Design ◽  
Prognostic Significance ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Future Research ◽  
Clinical Aspects ◽  
Special Focus ◽  
Increased Risk

Few issues of modern cardiovascular medicine have been as controversial as the relationship between white-coat hypertension (WCH), that is, a common condition in which office blood pressure is elevated while out-of-office blood pressure (ambulatory blood pressure or home blood pressure) is normal. While earlier studies showed no increased risk of cardiovascular events in WCH compared with the normotensive state, more recent studies have changed this conclusion by showing that an increased cardiovascular risk represents a trait of this hypertensive phenotype. The present article will review a number of issues related to WCH, that is, its definition, pathophysiological background, clinical alterations, and prognostic significance. This will be done by considering the available evidence published during the last decades, with special focus on the data collected in PAMELA (Pressioni Arteriose Monitorate e Loro Associazioni)—a research project performed with a cross-sectional and longitudinal design, which has provided a series of novel clinical information on WCH throughout the years. The final part of the article will discuss the therapeutic implications of the abovementioned evidence, as well as some controversial or still undefined issues related to WCH, whose investigation will be an important goal to pursue by future research.

Office blood pressure is a predictor of aortic elastic properties and urinary protein excretion in subjects with white coat hypertension

2016 ◽  
Vol 203 ◽  
pp. 98-103 ◽  
Author(s):  
Konstantinos Aznaouridis ◽  
Charalambos Vlachopoulos ◽  
Konstantina Masoura ◽  
Panagiota Pietri ◽  
Gregory Vyssoulis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elastic Properties ◽  
Urinary Protein Excretion ◽  
Urinary Protein ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Protein Excretion ◽  
Aortic Elastic Properties

scholarly journals White coat hypertension: current state of the issue

2021 ◽  
Vol 28 (2) ◽  
pp. 71-78
Author(s):  
K. H. Uvarova
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Treatment ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Prognostic Significance ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Lifestyle Modifications ◽  
Cardiovascular Morbidity And Mortality

More than 30 years have passed since the first description of such a concept as white coat hypertension was presented in the scientific literature, but since then, scientists are paying more and more attention to this condition. White coat hypertension is defined when the blood pressure readings obtained in the doctor’s office meet the criteria for hypertension, but the latter is not confirmed by outpatient or home blood pressure monitoring. Initially, the term was only applied to patients who had not received antihypertensive treatment, but recently this definition has been extended to people who regularly take drugs for lowering blood pressure, and this condition was called uncontrolled white coat hypertension. Some of the world’s most influential organizations in the field of cardiology have not reached a consensus on the definition of white coat hypertension on the background of common criteria, which has affected the differences in blood pressure thresholds according to outpatient monitoring. Quite a few studies in recent years have examined the clinical and prognostic significance of white coat hypertension in terms of its probable effects such as metabolic disorders, subclinical and extracardiac target organ damage, cardiovascular morbidity and mortality, and all-cause mortality. At present, there is no doubt that white coat hypertension is not an innocent condition; however, hypotheses about the prognostic role of this condition and the management of patients with white coat hypertension are still controversial. The question of treating white coat hypertension as a condition remains unsolved and requires further investigation. Today, it is considered most appropriate not to prescribe antihypertensive treatment to persons with office blood pressure at normal or below target levels, but to intensify lifestyle modifications and focus on reduction of cardiovascular risk.

P0149PREVALENCE OF MASKED HYPERTENSION IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ekaterina Borodulina ◽  
Alexander M Shutov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Home Blood Pressure ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Measurements

Abstract Background and Aims Arterial hypertension is main cause of left ventricular hypertrophy (LVH) in hemodialysis patients. Masked hypertension is associated with asymptomatic organ damage, including the development of LVH. The aim of this study was to investigate the prevalence of white-coat hypertension and masked hypertension in hemodialysis patients. Method Hemodialysis patients (n=88; 42 males, 46 females, mean age was 51.7±13.3 years) were studied. Office blood pressure measurements were performed before and after hemodialysis within 30 days. Home Blood Pressure Measurements (HBPM) was collected in the morning and in the evening during 4 weeks including hemodialysis session days. 24 hours blood pressure monitoring (ABPM) was performed in the next day after hemodialysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) were analyzed. White-coat hypertension was diagnosed when blood pressure elevated in the office, but was normal when was measured by ABPM, HBPM, or both. Masked hypertension was determined when blood pressure was normal in the office, but increased when was measured by HBPM or ABPM. The definitions of the European Society of Cardiology (2018 ESC/ESH Guidelines for the management of arterial hypertension) were used for the diagnosis of hypertension according to office, ambulatory, and home blood pressure levels. Echocardiographic evaluation was performed on the day after dialysis and left ventricular mass index (LVMI) was calculated. Results Arterial hypertension was diagnosed by office blood pressure measurements in 39 (44.3%) patients. Arterial hypertension was defined by ABPM (mean 24h BP > or = 130 and 80 mmHg) in 48 (54.5%) patients. The number of non-dipper patients was 59 (67.0%). According to HBPM arterial hypertension was observed in 61 (69.3%) patients. Left ventricular hypertrophy was detected in 71 (80.7%) patients. Mean LVMI was 140.5±43.0 g/m2. According to the results of three methods of blood pressure measuring arterial hypertension was diagnosed in 53 (60.2%) patients, white-coat hypertension was observed in 5 (5.7%) patients, masked hypertension – in 19 (21.6%) patients. Conclusion According to office blood pressure measurements arterial hypertension was diagnosed in 44.3% hemodialysis patients. Masked hypertension was often observed in hemodialysis patients and when using not only ABPM, but also HBPM was detected in 21.6% of patients. The results indicate the importance of using not only ABPM, but also HBPM in hemodialysis patients.

USEFULNESS OF A SERIES OF REPEATED IN-OFFICE BLOOD PRESSURE (ROBP) MEASUREMENTS FOR THE DIAGNOSIS OF WHITE-COAT HYPERTENSION

2008 ◽  
Vol 19 ◽  
pp. S35
Author(s):  
Giuseppe Crippa ◽  
Antonino Cassi ◽  
Claudio Venturi ◽  
Elena Bravi ◽  
Pietro Cavallotti
Keyword(s):  
Blood Pressure ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension
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