White Coat Hypertension Risk Index: Explanation and Clinical Context The White Coat Hypertension (WCH) Risk Index estimates the likelihood that a patient’s elevated office blood pressure readings are due to the white coat effect rather than sustained hypertension. It integrates office systolic and diastolic BP, age, sex, family history, and patient anxiety during measurement to calculate a probabilistic risk using a logistic model.
High WCH risk indicates that further evaluation using ambulatory or home blood pressure monitoring is warranted before initiating antihypertensive therapy. This tool helps clinicians avoid overtreatment, personalize management, and optimize diagnostic strategies.
Reference:
Sega R, Facchetti R, Bombelli M, et al. White coat hypertension: clinical and prognostic relevance. J Hypertens. 2001;19(12):2225-2232. doi:10.1097/00004872-200112000-00006