Does the white-coat effect in people of African and South Asian descent differ from that in White people of European origin? A systematic review and meta-analysis

Abstract

The blood pressure differences between Blacks and Whites are unlikely to be a result of variations in white-coat effect. In contrast, the slightly lower clinic blood pressure in some South Asian populations such as Bangladeshis might be partly caused by a low white-coat effect but more studies are needed in this subject.

The role of body weight, fat distribution and weight change in ethnic differences in the 9-year incidence of hypertension

“…Small previous studies suggest that South Asians may have a smaller rise in blood pressure due to the white-coat effect, in comparison to adults of white and African origin [32]. This could have led to bias through a relative large influence of temporary raised blood pressures, for example due to psychosocial stress or the white-coat effect.…”

Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: the Amsterdam Health Monitor Survey

“…As in several epidemiological surveys, our BP levels were based on two measurements at a single visit, which might have overestimated the prevalence of hypertension. The whitecoat effect differs between ethnic groups, and this may also affect our study conclusions [13]. Other potential sources of bias could have resulted from the relatively low response rate and differences in study sampling.…”

Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study

“…Nevertheless, these limitations should not limit the comparability of the ethnic groups within the study, since these limitations applied to all the ethnic groups. The white-coat effect also varies between different ethnic groups [23] and this may also affect our study findings. Finally, bias could have resulted from a differential response rate by an ethnic group.…”