Research Article Long-Term Risk of Progression to Sustained Hypertension in White-Coat Hypertension with Normal Night-Time Blood Pressure Values João Faria , 1 Jos´ e Mesquita Bastos , 2 Susana Bertoquini , 3 Jos´ e Silva , 3 and Jorge Pol´ onia 1 1 Department Medicine and Cintesis, Faculty of Medicine, University of Porto, Porto, Portugal 2 Health School of Aveiro University, Aveiro, Portugal 3 Hypertension Unit, Hospital Pedro Hispano, ULS, Matosinhos, Portugal CorrespondenceshouldbeaddressedtoJorgePol´ onia; jjpolonia@gmail.com Received 21 September 2020; Revised 11 November 2020; Accepted 10 December 2020; Published 22 December 2020 AcademicEditor:KaiHu Copyright©2020JoãoFariaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. e long-term prognosis and transition towards sustained ambulatory hypertension (SHT) of white-coat hyper- tension (WCHT) remain uncertain particularly in those with both normal nighttime and daytime blood pressure (BP) values. Differentclassificationcriteriaandtheuseofantihypertensivedrugsmaycontributetoconflictingresults. Patients and Methods. We prospectively evaluated for a 7.1 year transition to SHTin 899 nondiabetic subjects free from cardiovascular (CV) events: normotensive (NT) (n � 344;52,9%female;ageing48 ± 14 years); untreated WCHT (UnWCHT n � 399; 50, 1% female; ageing 51 ± 14 years); and treated WCHTwith antihypertensive drugs after baseline (TxWCHT n � 156; 54, 4% female; ageing 51 ± 15 years). All underwent 24h ambulatory BP monitoring (24h-ABPM) at baseline, at 30 to 60 months, and at 70 to 120 months thereafter. WCHT was at baseline (with no treatment) as office BP ≥ 140/or 90mm·Hg, daytime BP < 135/85mm·Hg, and nighttime BP < 120/70mm·Hg. Development of SHT was considered if daytime BP ≥ 135/or 85mm Hg and/or nighttime BP ≥ 120/or70mm·Hg. Results.Baselinemetabolicparametersdidnotdifferamonggroups.At30–60monthsandattheendof follow-up,developmentofSHToccurred,respectively,inNT(3.8%(n � 13)and9.6%(n � 33))andinUnWCHT(10.1%(n � 40) and 16.5% (n � 66)) (p < 0.009).emeanannualincreaseofaverage24h-systolicBPwas0.48+0.93inNTand0.73+1.06in UnWCHT, whereas annual SBP in office increased in NT by 1.2+0.95 but decreased in UnWCHT by 1.36+1.35mm Hg (p < 0.01). Conclusion. Untreated WCHT patients exhibit a faster and a higher risk of developing SHT compared to NT with TxWCHTassuming an intermediate position between them. 1. Introduction White-coat hypertension (WCHT) refers to the untreated condition in which high blood pressure (BP) values in the officecoexistwithnormalBPvalueswhenmeasuredby24h ambulatory blood pressure monitoring (24-ABPM), home blood pressure monitoring (HBPM), or both [1]. From its recognition in 1987, until now, the clinical prognosis of WCHT remains uncertain. Early longitudinal studies sug- gested that WCHT would be an innocent entity proposing that WCHT carries a similar risk to normotension and significantlylowerthansustainedhypertension(SHT)[2–6] even after adjusting for age and cardiovascular (CV) risk factors [4, 7–11]. In contrast, other studies and meta-ana- lyses suggest that WCHT carries a higher risk of CV mor- bidity and mortality and place it as an intermediate risk entitybetweenNTandSHT[8,10,12–19].However,overall these studies had a short duration and disparate inclusion criteria,particularlywithregardtothedefinitionofWCHT itself. In addition, in some studies, WCHT has been asso- ciated with a greater risk of transition for SHT, as well as overall increased risk of CV events [20–22]. Such contra- dictoryresultsmaybeexplainedbytheheterogeneityofthe studied populations, definition of WCHT and inclusion of Hindawi International Journal of Hypertension Volume 2020, Article ID 8817544, 8 pages https://doi.org/10.1155/2020/8817544