Risk of new-onsetmetabolic syndrome associatedwith white-coat andmasked hypertension: Data froma general population

Cesare Cuspidi, Rita Facchetti, Michele Bombelli, Carlac Sala, Marijana Tadic, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review


Aim: In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting newonset metabolic syndrome (MetS). Methods: The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat hypertension (WCH), masked hypertension and sustained hypertension. Results: Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR=1.75, CI 1.01-3.04, P=0.0046), masked hypertension (OR=2.58, CI 1.26-5.30; P=0.009) and sustained hypertension (OR=2.14, CI 1.20-3.79, P=0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-ofoffice BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P=0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion: Our study provides evidence that either isolated or combined BP elevations identified by office/ ambulatory measurements, carry an increased risk of newonset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

Original languageEnglish
Pages (from-to)1833-1839
Number of pages7
JournalJournal of Hypertension
Issue number9
Publication statusPublished - Sep 1 2018


  • General population
  • Metabolic syndrome
  • Office and out-of-office blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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