White Coat Hypertension in Children and Adolescents: Innocent or Not?

Background: The clinical significance of white coat hypertension is still uncertain. We aimed to evaluate children with white coat hypertension regarding their clinical, laboratory characteristics, evidence of target organ damage and compare them to normotensive and hypertensive children. Methods: Fourty patients diagnosed with white coat hypertension, 40 patients with primary hypertension and 40 normotensive children of similar age, gender and body mass index were included in the study. Ambulatory blood pressure monitoring and echocardiographic examination were performed to all children. Clinical and laboratory characteristics were noted. Results: All ambulatory blood pressure monitoring parameters, except night-time diastolic blood pressures and loads, were significantly higher in patients with white coat hypertension compared to normotensive ones. Left ventricular hypertrophy was 35% in the primary, 15% in the white coat hypertension group, and no left ventricular hypertrophy was detected in normotensive patients. No significant difference was found between 3 groups in terms of proteinuria or retinopathy. Conclusions: Children diagnosed with white coat hypertension had ambulatory blood pressure monitoring measurements and left ventricular mass index values smaller than patients with primary hypertension but more than normotensive children. Echocardiographic changes might suggest that white coat hypertension can be associated with target-organ damage.