What is white coat hypertension and why does it double the risk of fatal heart disease?

How does white coat hypertension affect heart disease?

New research suggests that white coat hypertension, when left untreated, is a major risk factor for heart disease and related deaths.

A recent study by the University of Pennsylvania found that white coat hypertension is a major contributor to heart disease and related death. The results of the study were published in the English-language journal "Annals of Internal Medicine".

What is white coat hypertension?

White coat hypertension describes a disorder in which a person only develops high blood pressure in the presence of doctors. Some experts assume that the condition is a result of the underlying fear. However, there is also a belief that white coat hypertension precedes and can contribute to the actual development of hypertension.

What does high blood pressure do?

Unfortunately, high blood pressure or high blood pressure affects more and more people today. Too high blood pressure increases the risk of heart attacks and strokes. Hypertension is defined as an upper value of at least 130 millimeters of mercury (mm Hg) or a lower value of 80 mm Hg or higher.

About one in five adults suffers from white coat hypertension

The latest research now suggests that white coat hypertension itself, like general high blood pressure, is a significant risk factor for heart disease and cardiovascular death. Untreated white coat hypertension in particular can increase the risk of dying from heart disease by more than 100 percent. Studies suggest that about one in five adults suffer from white coat hypertension. The results underline how important it is to identify people with this disease at an early stage, the researchers explain.

Data from 27 studies were evaluated

The authors of the study conducted a meta-analysis of 27 observational studies involving a total of more than 60,000 people. In each of the examinations, the health risks that correlated with white coat hypertension were analyzed, and a so-called follow-up examination of at least three years was carried out.

Heart disease risk was increased by 109 percent

In the meta-analysis, the researchers found that participants with untreated white coat hypertension increased the likelihood of heart disease by 36 percent, the likelihood of premature death by 33 percent and the risk of heart disease even increased by 109 percent. However, treated white coat hypertension did not correlate with a higher cardiovascular risk.

Blood pressure should also be measured at home

Untreated white coat hypertension is associated with an increased risk of cardiovascular events and increased all-cause mortality. Monitoring blood pressure outside the doctor's office is crucial for diagnosing and managing the disease, the researchers report. People with high blood pressure from the doctor who are not taking medicines for their blood pressure should be closely monitored to see whether there is a transition to persistent high blood pressure and whether the blood pressure is also high at home. For this, blood pressure should be measured in the practice and at home.

This is how you can protect yourself

This urgent need for constant monitoring should be a nationwide concern, as should certain lifestyle changes that improve people's cardiovascular health. People with untreated white coat hypertension are advised to make lifestyle changes, including quitting smoking, reducing alcohol consumption, eating healthier, and increasing exercise and physical activity.

Careful when taking medication

People with white coat hypertension who are already taking blood pressure medication should be careful when taking it, as this can lead to dangerously low blood pressure outside of the doctor's office, which can lead to unnecessary side effects from medication, the authors explain.

Were there any restrictions in the study?

Finally, the researchers also point out some limitations in their analysis, noting the insufficient number of studies evaluating isolated cardiac outcomes. In addition, the studies did not contain enough information about the race and ethnicity of the participants. (as)

Link to the original publication:

Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

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