Abstract Body: White coat hypertension (WCH) and white coat uncontrolled hypertension (WUCH) are phenomenon characterized by uncontrolled office blood pressures (BP) in the presence of normal out-of-office BPs among untreated and treated individuals, respectively. Although prior studies have investigated the reproducibility of WCH and WUCH, they were mainly limited to non-U.S. adults.

We assessed white coat status in 272 (75% treated) adults with elevated office BP(≥130/80 mmHg) who had home BP (HBP) measurements for three consecutive months without initiation or intensification of antihypertensive medications during the three-month time interval of interest. HBP measurements were included only when number of readings were ≥12/month. WCH and WUCH was defined as HBP≤130/80 mmHg in untreated and treated adults, respectfully. The reproducibility was assessed using the Kappa coefficient (K) with 95% confidence intervals (CI).

Mean age was 76±5 years (57% women, 12% Black adults). WCH was found in 39 of the 68 untreated adults with elevated office BP. WCH adults had an average home BP of 118/72±8/5 mmHg after the initial month of HBP monitoring (HBPM). As shown in Figure 1, 87% and 85% had WCH status confirmed on repeat assessment after an additional one- and two-month interval of HBPM (K=0.54 and 0.48, respectfully). WUCH was found in 92 of the 204 treated adults with elevated office BP and had an average home BP of 120/71±5/5 mmHg. Of those, 86% and 84% had WUCH confirmed on repeat assessment after an additional one- and two-month interval of HBPM (K=0.65 and 0.52, respectfully).

In conclusion, WCH and WUCH phenotypes when assessed by home blood pressure monitoring exhibited fair-to-moderate reproducibility among U.S. adults.