title: Diagnosis and management of patients with white-coat and masked hypertension.
abstract: White-coat hypertension is characterized by an elevation in clinic blood pressure but normal home or ambulatory blood-pressure values, whereas patients with masked hypertension have normal clinic blood pressure and elevated ambulatory or home blood-pressure load. Both white-coat and masked hypertension are frequent clinical entities that need appropriate recognition and a close diagnostic follow-up. White-coat and masked hypertension seem to be associated with organ damage and increased cardiovascular risk, although not invariably. In addition, patients with masked or white-coat hypertension have an increased risk of abnormalities affecting their glucose and lipid profiles. Therefore, the diagnosis of these conditions should be accurate and include the assessment of cardiovascular as well as of metabolic risk. Once diagnosed, first-line therapeutic interventions should be nonpharmacological and aim at lifestyle changes, but drug treatment can be indicated, particularly when the patient's cardiovascular risk profile is elevated or when target-organ damage is detected.
authors.affiliation: Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Via Pergolesi 33, 20052 Monza, Italy. giuseppe.mancia@ unimib.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Gino
authors.initials: G
authors.lastname: Seravalle
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D006801:Humans; D059468:Masked Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000959:Antihypertensive Agents