['White-coat hypertension (WCH) is a prevalent entity, which has been associated with an increased cardiovascular risk.', 'Assess whether WCH is associated with a higher coronary atherosclerotic burden, evaluated by coronary computed tomography angiography (CCTA) and coronary artery calcium (CAC) scoring.', 'A total of 1362 patients who performed CCTA and simultaneous CAC for the assessment of coronary artery disease (CAD) were prospectively enrolled in a single-center registry and divided into three groups: (A) patients with normal blood pressure (BP) (n=386); (B) patients with WCH (n=174; without a history of hypertension or antihypertensive medication, but with systolic BP ≥140 and/or diastolic BP ≥90\u2009mmHg before examination acquisition); and (C) patients with hypertension (n=802). The following coronary atherosclerotic markers were evaluated: CAC above the 50th percentile (CAC>p50), prevalence of CAD (any plaque), and obstructive CAD (plaque with>50% stenosis).', 'Patients with WCH had a higher coronary atherosclerotic burden compared with patients with normal BP for all markers (30.5 vs. 19.4%, P=0.004 for CAC>p50; 50.6 vs. 36.8%, P=0.002 for CAD, any plaque; and 13.8 vs. 8.3%, P=0.045 for obstructive CAD). On multivariate analysis, WCH was an independent predictor of a CAC>p50 [odds ratio (OR) 1.563, 95% confidence interval 1.018-2.400, P=0.041], but not of the presence of CAD (any plaque) (OR 1.335, P=0.169) or obstructive CAD (OR 1.376, P=0.301).'] Is white-coat hypertension during coronary computed tomography angiography associated with higher coronary atherosclerotic burden?