(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 in the Annals of Internal Medicine.

Jordana B. Cohen, MD, 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 3 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% confidence interval, 1.03 to 2.00], 1.33 [95% confidence interval, 1.07 to 1.67], and 2.09 [95% 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% confidence interval, 1.00 to 1.54). Treated WCE was not significantly associated with cardiovascular events (hazard ratio, 1.12; 95% confidence interval, 0.91 to 1.39), all-cause mortality (hazard ratio, 1.11; 95% confidence interval, 0.89 to 1.46), or cardiovascular mortality (hazard ratio, 1.04; 95% 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.


Cohen JB, Lotito MJ, Trivedi UK, et al. Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis. Ann Intern Med.

Shimbo D and Muntner P. Should Out-of-Office Monitoring Be Performed for Detecting White Coat Hypertension? Ann Intern Med.