What is the best way to treat patients with white-coat hypertension?

Abstract

Evidence is conflicting regarding the risk of cardiovascular complications from white- coat hypertension. Some but not all studies show lower cardiovascular event rates for patients with white-coat hypertension compared with those with sustained hypertension (strength of recommendation [SOR]: B, cohort studies with conflicting results and methodological problems). Little information is available about the use of antihypertensive medication for white-coat hypertension. In 1 small randomized trial, the difference in stroke incidence and cardiovascular complications between active treatment and placebo did not reach statistical significance (SOR: B, based on an underpowered randomized controlled trial). Some experts recommend that patients with white-coat hypertension should be evaluated for evidence of target organ injury and monitored for the development of sustained hypertension (SOR: C, expert opinion).