White-coat hypertension as a risk factor for the development of home hypertension: The Ohasama study

Takashi Ugajin, Atsushi Hozawa, Takayoshi Ohkubo, Kei Asayama, Masahiro Kikuya, Taku Obara, Hirohito Metoki, Haruhisa Hoshi, Junichiro Hashimoto, Kazuhito Totsune, Hiroshi Satoh, Ichiro Tsuji, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

129 Citations (Scopus)


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 ≥140/90 mm Hg) for 8 years and compared the risk of progression with home hypertension (home BP ≥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 mmHg) 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)1541-1546
Number of pages6
JournalArchives of Internal Medicine
Issue number13
Publication statusPublished - 2005 Jul 11

ASJC Scopus subject areas

  • Internal Medicine


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