White coat hypertension may increase the risk of premature death: Study

Darielle Britto | Jul 11, 2019, 12:44 IST
A new study explains why you shouldn't ignore signs of white coat hypertension - when a patient exhibits higher blood pressure levels at the doctor's office than in other settings. The risk of premature death from heart disease or stroke is extremely high for those with untreated white coat hypertension, according to researchers.

"People with white-coat hypertension may not be monitored regularly. They may feel like nothing is wrong," study author Dr Jordana Cohen, an assistant professor in the division of Renal-Electrolyte and Hypertension at the University of Pennsylvania School of Medicine in Philadelphia, told a news portal. Cohen urges people to be aware of their blood pressure levels. "Know what your blood pressure is, and what your goal is. Learn how to take blood pressure so you get a quality blood pressure reading. I think everyone should have a home monitor, even if their health care provider doesn't specifically recommend it," she told a news portal.

High blood pressure is defined as a top reading of at least 130 millimetres of mercury (mm Hg) or a bottom reading of 80 mm Hg or higher.

For the study, the team conducted a meta-analysis of close to 27 observational studies that included almost 60,000 participants. These studies made note of the risks linked with white coat hypertension. Through their investigation, the team learned the following about untreated white coat hypertension:

*36 per cent of the patients were more likely to develop heart disease
*33 per cent of the patients were more likely die prematurely from any cause
* 109 per cent of the patients were more likely to die of heart disease

"Untreated [white coat hypertension], but not treated [white coat effect], is associated with an increased risk for cardiovascular events and all-cause mortality. Out-of-office [blood pressure] monitoring is critical in the diagnosis and management of hypertension,"Cohen told a news portal. Adding, "We believe individuals with isolated in-office hypertension — those who are not taking blood pressure medication — should be closely monitored for transition to sustained hypertension, or elevated blood pressure both at home and the doctor's office."

Cohen also urges people to make lifestyle changes in order to improve their heart health. "Simultaneously, we advise individuals with untreated white coat hypertension to engage in lifestyle modifications, including smoking cessation, reduction in their alcohol intake, and making improvements to their diet and exercise regimen," Cohen told a news portal. Adding, "We also caution providers not to overtreat individuals with white coat hypertension who are already on blood pressure medication, as this could lead to dangerously low blood pressures outside of the office and unnecessary side effects from medication."

The study's findings were originally published in the Annals of Internal Medicine.
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