Cardiovascular prognosis of sustained and white-coat hypertension in patients with type 2 diabetes mellitus

Kazuo Eguchi, Satoshi Hoshide, Joji Ishikawa, Shizukiyo Ishikawa, Thomas G. Pickering, William Gerin, Gbenga Ogedegbe, Joseph E. Schwartz, Kazuyuki Shimada, Kazuomi Kario

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Cardiovascular prognosis in diabetic white-coat hypertension (WCH) has not yet been described. We designed this study to investigate the impact of WCH on cardiovascular events in patients with type 2 diabetes, compared with those having type 2 diabetes along with sustained hypertension (SH), and with nondiabetic hypertensive individuals. METHODS: We performed ambulatory blood pressure (BP) monitoring in 1207 consecutive hypertensive patients at baseline, and they were followed up for 49±22 months. The mean age was 70.7±9.8 years; 262 had type 2 diabetes; and 945 did not. They were classified as having SH with diabetes (n=210); diabetic WCH (n=52); SH alone (n=719); or WCH alone (n=226), using awake BP of 135/85 mmHg as the cutoff value. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals of the risk for cardiovascular events, after controlling for age, sex, body mass index, current smoking, serum creatinine, and clinical systolic BP. RESULTS: During the follow-up period, 97 cardiovascular events occurred. The incidence of cardiovascular events in the diabetic SH group was significantly higher than in the diabetic WCH, nondiabetic SH, and nondiabetic WCH (P<0.05; log-rank test) groups. In Cox regression analysis, the diabetic SH group had significantly higher risk of cardiovascular events compared with the diabetic WCH group (HR: 8.2; 95% confidence intervals: 1.09-61.8; P=0.04). Although nonsignificant, the HRs in the SH and WCH groups, relative to diabetic WCH, exceeded 3.0. CONCLUSIONS: The cardiovascular prognosis for diabetic WCH was better than that for diabetic SH during 4 years of follow-up.

Original languageEnglish (US)
Pages (from-to)15-20
Number of pages6
JournalBlood Pressure Monitoring
Issue number1
StatePublished - Feb 2008


  • Ambulatory blood pressure monitoring
  • Cardiovascular events
  • Type 2 diabetes
  • White-coat hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing


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