White-coat and masked hypertension and coronary artery disease. are they related or not?

Currently, high blood pressure (BP) may cover different hypertension phenotypes, including white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT), all of which are characterized by substantially higher risk of cardiovascular (CV) events and mortality than normotension (NT) [1–5]. This has recently been reaffirmed by the latest sets of European guidelines [6], which emphasized the role of out-of-office BP assess- ment, such as 24-h ambulatory and home BP monitoring, to properly stratify apparently low-risk individuals with high- normal BP levels. The same guidelines also recommended that a search for hypertension-mediated organ damage or other risk factors and comorbidities should be performed in patients with WCHT or MHT, in view of the relative frequency of these risk factors and markers of organ damage in these hypertensive patients [6]. Despite this evidence, both WCHT and MHT are often undiagnosed or even untreated. Findings from large national databases or clinical studies have clearly demon- strated that both of these conditions are relatively common in the clinical practice of hypertension [7]. Other studies have also reported that, even in the presence of anti- hypertensive treatment, effective BP control is not achieved in patients with WCHT or MHT, with obvious and relevant consequences on the risk of developing major CV out- comes [8–10].