In a recent meta- analysis, white-coat hypertension was associated with a Not taking antihypertensive medication White-coat hypertension Sustained hypertension Normotension Masked hypertension Hypertension based on standardized office BP Hypertension based on out-of-office BP Yes Yes No No Taking antihypertensive medication White-coat effect Sustained uncontrolled hypertension Sustained controlled hypertension Masked uncontrolled hypertension Hypertension based on standardized office BP Hypertension based on out-of-office BP Yes Yes No No Figure 4 | Blood pressure patterns informed by out-of-of ce blood pressure measurements in addition to standardized of ce blood pressure measurement. www.kidney-international.org chapter 1 modest increased risk for CV disease, compared to sustained However, this risk was substantially lower than the risk for participants with sustained hypertension.31 Additionally, the white-coat effect was not associated with increased risk for CV disease when compared to the risk for people with sustained controlled hypertension.29 The prevalences of white-coat hypertension, masked hypertension, the white-coat effect, and masked uncon- trolled hypertension are each high among patients with Identi cation of white-coat hypertension and masked hypertension for patients not taking antihypertensive medication, and the white-coat effect and masked uncon- trolled hypertension for patients taking antihypertensive medication may have potential treatment implications (see Rationale section). However, it remains to be determined whether initiation of antihypertensive medication among patients with white-coat hypertension and masked hyper- tension, or intensi cation of antihypertensive medication among patients with the white-coat effect and masked uncontrolled hypertension improves outcomes (see Research Recommendations). This recommendation places a relatively lower value on the potential lack of device availability, costs, and patient and staff burden. Quality of evidence. 