Is white-coat hypertension a risk factor for carotid atherosclerosis? A review and meta-analysis
Why this work is in the frame
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Bibliographic record
Abstract
The association of white-coat hypertension (WCH) with target organ damage is still debated; in particular, the relationship of this blood pressure phenotype with subclinical vascular damage remains controversial. Thus, we carried out a systematic review and meta-analysis to provide updated information on carotid structural changes in WCH. Studies were identified using the following search terms: 'white coat hypertension', 'isolated clinic hypertension', 'carotid artery', 'carotid atherosclerosis', 'carotid intima-media thickness', 'carotid damage', 'carotid thickening'. Full articles published in the English language in the last two decades reporting studies on adults were considered. A total of 3478 untreated patients, 940 normotensive (48% men), 666 WCH (48% men), and 1872 hypertensive individuals (57% men) included in 10 studies, were analyzed. Common carotid intima-media thickness (IMT) showed a progressive increase from normotensive (718±36 μm) to WCH (763±47 μm, standardized mean difference 0.54±0.13, P<0.01) and to hypertensive patients IMT (817±47 μm, standardized mean difference 0.45±0.14, P<0.01). After assessing data for publication bias, only the difference between normotensive and WCH patients remained significant. Our meta-analysis documents that common carotid IMT, a prognostically validated marker of vascular damage, is greater in WCH patients than in true normotensive individuals and is not different from sustained hypertensives. This finding supports the concept that WCH is not an entirely benign condition.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.010 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it