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(Hypertension. 2005;45:183.)
© 2005 American Heart Association, Inc.

Editorial Commentaries

White-Coat Hypertension and Risk of Stroke

Do the Data Really Tell Us What We Need to Know?

From the Diabetes Epidemiology & Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Ariz.

Correspondence to Dr Paul W. Franks, Diabetes Epidemiology &Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, 1550 E. Indian School Rd, Phoenix, AZ 85014. E-mail pfranks@niddk.nih.gov

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The term "white-coat hypertension" (WCH; also commonly referred to as isolated office hypertension) describes the transient increase in blood pressure (BP), resulting from an alerting reaction and pressor response, observed in certain individuals when attending a clinic or doctors’ office.¹ The diagnosis of WCH is usually ascribed when clinic BPs exceed 135/85 mmHg and average daytime BPs do not. WCH could be dismissed as a risk factor for stroke and other cardiovascular events, because the increase in BP is transient and may be idiosyncratic to the clinic setting.² However, WCH may be a marker of stress reactivity per se, because surges in BP that occur in the doctor’s office are indicative of BP surges in other stressful scenarios.³

The article by Verdecchia et al featured in this edition of Hypertension⁴ reports data from 6000 Italian, Japanese, and American adults. The purpose of the study was to explore the relationship between classically defined WCH and incident stroke during a median follow-up of 5.4 years. When compared with normotensive controls, a tendency for increased stroke incidence was observed in patients with WCH (unadjusted hazard ratio, 1.15). However, because the variance around the estimates of effect is large (95% confidence interval, 0.61 to 2.16), this association is not statistically significant, despite this study being the largest of its kind to date. By contrast, a statistically significantly association between ambulatory hypertension and stroke was observed (unadjusted hazard ratio, 2.01; 95% confidence interval, 1.31 to 3.08).

The hypothesis that Verdecchia et al test is important . . . [Full Text of this Article]

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