Blood pressure on arising, morning blood pressure surge and blood pressure variability in white coat hypertensives and in matched normotensives and sustained hypertensives.
Level 4 - case-series / case-control
Matched cross-sectional comparative study
What was done
Researchers evaluated 24-hour ambulatory blood pressure monitoring records to measure morning blood pressure (BP) surge, BP on arising, and daytime BP variability (systolic standard deviation). They compared 74 individuals with white-coat hypertension (WCHT; age 52 ± 8 years, 57% female, BMI 26 ± 2) against matched cohorts of 69 normotensives (NT; age 49 ± 7 years, 54% female, BMI 26 ± 1) and 79 untreated sustained hypertensives (HT; age 53 ± 7 years, 56% female, BMI 27 ± 2).
What was found
- BP on arising: WCHT (121/81 ± 13/8 mmHg) was similar to NT (120/80 ± 13/9 mmHg, non-significant), and both were lower than HT (137/92 ± 17/10 mmHg, p < 0.01). - Systolic morning BP surge: WCHT was higher than NT (25 ± 10 vs. 22 ± 11 mmHg, p < 0.05), but lower than HT (33 ± 11 mmHg, p < 0.01 vs. NT and WCHT). - Daytime systolic BP variability: WCHT was higher than NT (12 ± 2 vs. 10 ± 2 mmHg, p < 0.05), but lower than HT (14 ± 3 mmHg, p < 0.01 vs. NT and WCHT).
Why it matters
The study suggests that white-coat hypertension is accompanied by intermediate alterations in morning blood pressure surge and daytime variability, falling between normotensive and sustained hypertensive profiles.
Limits
The study is cross-sectional with modest subgroup sizes (69 to 79 per arm). It only measured hemodynamic parameters and did not assess long-term cardiovascular outcomes or clinical endpoints.
Cited by
- supports Systolic blood pressure can jump 20 to 25 points in the first hour after waking up.