DOES WHITE COAT HYPERTENSION END WITH HYPERTENSION? A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Office blood pressure (BP) can be influenced by an alerting reaction to the clinical setting, giving rise to white-coat hypertension (WCH), long regarded as a benign phenotype. Whether WCH genuinely progresses to sustained hypertension remains debated. This review aimed to determine the pooled risk of progression from WCH to sustained hypertension and to explore the influence of diagnostic method, follow-up duration, and population characteristics on this risk. Methods:Following PRISMA 2020 and Cochrane Handbook guidance, MEDLINE/PubMed, Web of Science, Scopus, CENTRAL, Science Direct, and ClinicalTrials.gov were searched from inception to 3 July 2026 for observational cohort studies classifying untreated participants as WCH or normotensive using paired office and out-of-office BP, with repeated assessment at follow-up. Risk of bias was assessed using the QUIPS tool.