Office white-coat effect tail and long-term cardiovascular risks in 60-year follow-up of the European cohorts of the Seven Countries Study.

Abstract

Aim: The aim of this study was to determine whether the office white-coat effect tail (OWCET), defined as decreasing of SBP ≥10 mmHg in multiple office systolic blood pressure measures, predicts major long-term fatal events in the nearly extinct European cohorts of the Seven Country Study (ECSCS).

Material and methods: In the present analysis, 4,937 men (49 ± 5 years) were included. All-cause mortality and specific mortalities [cardiovascular mortality (CVD) including stroke, coronary heart disease (CHD) death as well as heart disease of uncertain aetiology (HDUE)] were considered using Cox models. Also non-CVD deaths were studied by Fine-Gray competing risk analysis.

Results: At inclusion, subjects with OWCET were significantly more hypertensive. After 60-year follow-up, OWCET was not associated with risk of both CVD [aHR: 0.95 (95% CI: 0.82-1.03), p = 0.5] and all-cause death [aHR: 0.92 (95% CI: 0.82-1.03), p = 0.16] independently of traditional risk factors (age, SBP, BMI, total cholesterol and cigarettes) in ECSCS. Same results were found for Northern and Southern Europe cohorts of ECSCS concerning CVD death [aHR: 0.98 (95% CI: 0.76-1.26), p = 0.85 and aHR: 0.95 (95% CI: 0.74-1.20), p = 0.66] and all-cause death, respectively [aHR: 0.90 (95% CI: 0.75-1.07), p = 0.23 and aHR: 0.93 (95% CI: 0.79-1.09), p = 0.38].

Conclusions: In a general population of men, OWCET is not associated to CVD or non-CVD and all-cause mortality and consequently cannot improve stratification of long-term CVD risks in ECSCS.