Perelman School of Medicine at the University of Pennsylvania, Renal Electrolyte and Hypertension Division, 122 Founders Building 3400 Spruce Street, Philadelphia, PA, United States.
Curr Hypertens Rep. 2024 Oct;26(10):399-407. doi: 10.1007/s11906-024-01309-0. Epub 2024 May 18.
This review aims to inform the reader of the complexity of blood pressure responses when comparing blood pressure measured in the medical environment to that outside the medical environment. In addition, we summarize what is known about current predictors of white coat hypertension, reevaluate the relationship of white coat hypertension to cardiovascular outcomes, and provide some clinical guidance on management.
Differences in outcomes exist when white coat effect occurs in unmedicated people versus the white coat effects in those on antihypertensive therapy. White coat hypertension is relatively common, carries a small but definite increase in cardiovascular risk, and is prone to conversion to sustained hypertension. Future research will hopefully tease out the roles of ancillary findings that characterize a white coat hypertensive (like modest elevations in creatinine, glucose and triglycerides) in the elevated cardiovascular risk, and test the effectiveness of mitigation strategies in these patients.
本篇综述旨在向读者阐明在比较医疗环境与医疗环境外血压测量值时血压反应的复杂性。此外，我们总结了目前关于白大衣高血压预测因素的知识，重新评估白大衣高血压与心血管结局的关系，并提供一些管理方面的临床指导。
在未接受药物治疗的人群中与接受抗高血压治疗的人群中出现白大衣效应时，结果存在差异。白大衣高血压较为常见，会使心血管风险略有但明确增加，并且容易转化为持续性高血压。未来的研究有望阐明那些表现出白大衣高血压特征的辅助发现（如肌酐、葡萄糖和甘油三酯的适度升高）在升高的心血管风险中的作用，并测试这些患者中缓解策略的有效性。
