I read with interest the article on IOH by Grandi et al1 and the accompanying editorial by Dr Moser.2 Grandi and colleagues concluded that IOH, also known as white-coat hypertension, "should not be considered as simply a benign condition," because they found that patients with IOH have evidence of increased left ventricular mass and wall hypertrophy and reduced diastolic function compared with normotensive subjects. Their study also showed that isolated office BP in patients with IOH (154/93 mm Hg) was similar to that in patients with sustained hypertension (153/93 mm Hg). However, on 24-hour ambulatory BP monitoring, daytime systolic (126 ± 5 mm Hg) and diastolic (74 ± 6 mm Hg) BP levels in subjects with IOH were similar to those in normotensive subjects (125 ± 6 and 74 ± 6 mm Hg, respectively); that was also true for the nighttime BP levels (109 ± 10 and 63 ± 13, respectively, in subjects with IOH and 108 ± 11 and 64 ± 12, respectively, in normotensive subjects). The BP levels in both groups were significantly (P<.001) lower than those in the sustained hypertensive group.
Hayreh SS. Treatment of IOH and Risk of Visual Complications. Arch Intern Med. 2002;162(13):1526-1528. doi: