The Effect Of White Coat Hypertension On Heart Damage: A Meta-analysis

Objective:We conducted a meta-analysis to evaluate the effect of white coat hypertension on subclinical heart damage compared with normotensive and sustained hypertension.Methods:The databases of Pub Med(MEDLINE),Cochrane Library,Web of Science and EMBASE were searched to idented studies of subclinical heart damage among normotensive,sustained hypertension and white coat hypertension.The random effect model was used to calculate the differences of left ventricular hypertrophy rate and left ventricular mass index among normotensive,sustained hypertension and white coat hypertension,and the heterogeneity was evaluated by I~2 statistics and Q test.Results:We included 22 studies with 30581 participants(17915normotensive patients,9046 white coat hypertension patients and 3620sustained hypertension patients).Compared with the normotensive group,the white coat hypertension group had a higher left ventricular hypertrophy rate,left ventricular mass index,left atrium diameter and relative wall thickness.Compared with the sustained hypertension group,the left ventricular hypertrophy rate and left ventricular mass index of the white coat hypertension group were significantly lower,but the E/A ratio was significantly greater.And the interventricular septal thickness,the left atrium diameter,left ventricular diameter,left ventricular ejection fraction,posterior wall thickness and relative wall thickness in the white coat hypertension group were not significantly different from those in the sustained hypertension group.Conclusion:These results indicate that the risk of subclinical heart damage in patients with white coat hypertension may be between those with normotensive and those with sustained hypertension.This phenotype of hypertension maybe is not entirely innocuous clinically.