Evidence map›Paper›PMID 31181575›Full record

SynthesisAnnals of internal medicine2019

Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis.

Jordana B Cohen, Michael J Lotito, Usha K Trivedi, Matthew G Denker, Debbie L Cohen, Raymond R Townsend

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Annals of internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 7 pooled it
16.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 7 syntheses or guidelines pooled it, 190 citations in OpenAlex.

  1. Pooled it
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  4. Telemonitoring of Real-World Health Data in Cardiology: A Systematic Review.International journal of environmental research and public health · 2021
    Pooled it
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  8. Trial
  9. Trial
  10. Trial
  11. Differences in Office and Ambulatory Pulse Wave Analysis in Patients with White Coat Hypertension and Other Hypertension Phenotypes.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Article
  12. Subtypes of Hypertension 2 to 7 Years After First Pregnancy.Hypertension (Dallas, Tex. : 1979) · 2026
    Observational
  13. Review
  14. Article
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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Jordana B CohenUniversity of Pennsylvania, Philadelphia, Pennsylvania (J.B.C., M.G.D., D.L.C., R.R.T.).
Michael J LotitoPrinceton University, Princeton, New Jersey (M.J.L.).
Usha K TrivediRutgers New Jersey Medical School, Newark, New Jersey (U.K.T.).
Matthew G DenkerUniversity of Pennsylvania, Philadelphia, Pennsylvania (J.B.C., M.G.D., D.L.C., R.R.T.).
Debbie L CohenUniversity of Pennsylvania, Philadelphia, Pennsylvania (J.B.C., M.G.D., D.L.C., R.R.T.).
Raymond R TownsendUniversity of Pennsylvania, Philadelphia, Pennsylvania (J.B.C., M.G.D., D.L.C., R.R.T.).
University of Pennsylvania · USPrinceton University · USRutgers New Jersey Medical School

Funding

Management of hypertension in obesity: Antihypertensive class effects, blood pressure control, and renal and cardiac outcomesK23HL133843 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI COHEN, JORDANA B. · 2016 to 2020
$945k
NHLBI NIH HHS K23 HL133843
6 · The paper itself

Abstract

Background: The long-term cardiovascular risk of isolated elevated office blood pressure (BP) is unclear. Purpose: To summarize the risk for cardiovascular events and all-cause mortality associated with untreated white coat hypertension (WCH) and treated white coat effect (WCE). Data Sources: PubMed and EMBASE, without language restriction, from inception to December 2018. Study Selection: Observational studies with at least 3 years of follow-up evaluating the cardiovascular risk of WCH or WCE compared with normotension. Data Extraction: 2 investigators independently extracted study data and assessed study quality. Data Synthesis: 27 studies were included, comprising 25 786 participants with untreated WCH or treated WCE and 38 487 with normal BP followed for a mean of 3 to 19 years. Compared with normotension, untreated WCH was associated with an increased risk for cardiovascular events (hazard ratio [HR], 1.36 [95% CI, 1.03 to 2.00]), all-cause mortality (HR, 1.33 [CI, 1.07 to 1.67]), and cardiovascular mortality (HR, 2.09 [CI, 1.23 to 4.48]); the risk for WCH was attenuated in studies that included stroke in the definition of cardiovascular events (HR, 1.26 [CI, 1.00 to 1.54]). No significant association was found between treated WCE and cardiovascular events (HR, 1.12 [CI, 0.91 to 1.39]), all-cause mortality (HR, 1.11 [CI, 0.89 to 1.46]), or cardiovascular mortality (HR, 1.04 [CI, 0.65 to 1.66]). The findings persisted across several sensitivity analyses. Limitation: Paucity of studies evaluating isolated cardiac outcomes or reporting participant race/ethnicity. Conclusion: Untreated WCH, but not treated WCE, is associated with an increased risk for cardiovascular events and all-cause mortality. Out-of-office BP monitoring is critical in the diagnosis and management of hypertension. Primary Funding Source: National Institutes of Health.

Indexed as

Blood Pressure Monitoring, AmbulatoryCardiovascular DiseasesCause of DeathHumansWhite Coat Hypertension

Identifiers

PMID31181575
PMCPMC6736754
OpenAlexW2950193649

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.