White-coat hypertension as a risk factor for the development of home hypertension: the Ohasama study.
BACKGROUND
White-coat hypertension is a condition characterized by elevated blood pressure (BP) in medical settings combined with normal ambulatory-recorded BP or self-measured BP at home (home BP). However, it is unknown whether this condition represents a transient state in the development of hypertension outside medical settings.


METHODS
We followed up 128 subjects with white-coat hypertension (home BP <135/85 mm Hg and office BP > or = 140/90 mm Hg) for 8 years and compared the risk of progression with home hypertension (home BP > or = 135/85 mm Hg or start of treatment with antihypertensive medication) with 649 sustained normotensive subjects (home BP <135/85 mm Hg and office BP <140/90 mm Hg) using data from population-based home BP measurement projects in Japan.


RESULTS
During the 8-year follow-up period, 60 subjects (46.9%) with white-coat hypertension and 144 (22.2%) with sustained normotension progressed to home hypertension. The odds ratio of subjects with white-coat hypertension for progression to home hypertension (adjusted for possible confounding factors) was significantly higher than for subjects with sustained normotension (odds ratio, 2.86; P<.001). This association was observed independent of baseline home BP levels.


CONCLUSIONS
The results from the present 8-year follow-up study demonstrate that white-coat hypertension is a transitional condition to hypertension outside medical settings, suggesting that white-coat hypertension may carry a poor cardiovascular prognosis.
Ugajin
Takashi
T
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Medicine and Pharmaceutical Sciences, Sendai, Japan.
Hozawa
Atsushi
A
Ohkubo
Takayoshi
T
Asayama
Kei
K
Kikuya
Masahiro
M
Obara
Taku
T
Metoki
Hirohito
H
Hoshi
Haruhisa
H
Hashimoto
Junichiro
J
Totsune
Kazuhito
K
Satoh
Hiroshi
H
Tsuji
Ichiro
I
Imai
Yutaka
Y
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index