Antihypertensive drugs confer durable BP reduction in white-coat hypertension

Antihypertensive medications prove to be effective and lasting in decreasing office blood pressure (BP) among individuals with white-coat hypertension (WCH), suggests a study.

“This reduction is accompanied by the inability to lower ambulatory BP from the normal values characterizing this condition at baseline,” the authors said. “This appears to be unrelated to the type of treatment employed.”

Data from the Plaque HYpertension Lipid-Lowering Italian Study (PHYLLIS) were used to assess the effect of antihypertensive treatment on office and ambulatory BP in WCH. The authors measured both types of BP in 470 hypertensive patients randomized to fosinopril or hydrochlorothiazide alone or combined with a statin before treatment and at 6-month or yearly intervals during 2.6 years of follow-up.

Participants were grouped into two based on whether their office and 24-h mean BP were elevated before randomization to treatment (sustained hypertension) or their office BP was elevated but 24-h BP values were normal (WCH).

Treatment with antihypertensive medication in both sustained hypertension and WCH resulted in an early marked reduction in office BP, which persisted throughout the treatment period. On the other hand, 24-h (and day and night) BP decreased substantially and continually with treatment in sustained hypertension, but there was no change in WCH.

“The results were similar when data were separately analysed in patients under fosinopril or diuretic, with or without statin treatment,” the authors said.