White Coat Hypertension

By on September 2, 2012 with No Comments

White coat hypertension is a condition when people are diagnosed with high blood pressure in a clinical setting although in normal case they may not have the condition. A patient shows a sign of elevated blood pressure when it is measured and this is thought to be induced by anxiety which people may experience when they visit a clinic. What happens is that when some people enter a doctor’s office, their blood pressure is elevated and when they get away from the environment, the pressure subsides.

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These people may show an increased systolic blood pressure between 140 and 180 mmHg when they enter the doctor’s office or when they are in a clinic and when they are out of that setting, the condition subsides. It is even argued that no treatment is required for this condition.

Similarly, masked hypertension is a term used to refer to a phenomenon where blood pressure increases during daily living and not in a doctor’s clinic. Daytime ambulatory blood pressure is used in referencing the pressure of blood because it mainly takes into consideration the ordinary levels of daily stress. There are often problems that are experienced when diagnosing and treating white coat hypertension.

White coat hypertension is thus defined as an increased systolic blood pressure that is between 140 and 180 mmHg when a person is in a clinic or doctor’s office and a normal systolic pressure reading of not more than 140 mmHg and diastolic pressure of not more than 90 mmHg when a person leaves or is away from a clinic setting or doctor’s office.

Tension and anxiety can cause blood pressure to temporarily increase and this could be one of the reasons why people reportedly record normal blood pressure when they are away from doctor’s office and get increased pressure when they enter the doctor’s office.

When your doctor suspects that you may be having white coat hypertension, then he or she may recommend that you further monitor the pressure of the blood in different settings. You may be asked to measure your blood pressure when you are at home. The doctor may also ask you to wear a device, which is called ambulatory blood pressure monitor. The device is worn 24 hours and takes blood pressure measurements every 30 minutes and this is likely to give the different sets of pressure reading in different environments.

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The diagnosis of hypertension mainly depends on how a person’s state of restfulness is achieved just before the testing. Theoretically, the doctor’s office is considered the most restful and quiet environment in which pressure reading can be taken. However, there are conditions which may stimulate quiet rest and these affects the ability to get the right readings for blood pressure.

The formal guidelines for measuring blood pressure require that the patient rest comfortably in a warm and quiet environment for a period of about 5 minutes before the reading is taken. However, the nature of doctors offices these days have changed and the environment is characterized by cold sterile and harried environment, which does not give the patient the ideal condition to relax the body and the mind.

There is a perception that based on the doctors’ offices nowadays, white coat hypertension may not necessarily reflect a state of anxiety and tension but it may actually be infeasibility to access a state of quiet restfulness in such a place.

In normal circumstances, antihypertensive drug medication is not recommended for patients who experience white coat hypertension but it is essential that the patient’s high blood pressure is monitored over time and appropriate lifestyle change recommended. Generally, people with white coat hypertension have lower morbidity compared to their counterparts with established or sustained hypertension.

Nonetheless, the white coat hypertensive people have a higher morbidity than the clinically normotensive persons. The treatment which is provided for white coat hypertension is based on established published trails that are built on the consequence and implications of high blood pressure and the benefits of the treatment.

Therefore, based on the one time clinical measurement rather than the slightly lower reading that is obtained from an ambulatory reading shows that there is conflicting issues about the treatment of the condition. A person may be administered of drugs of high blood pressure based on the readings from the doctors’ offices and this may not show the true picture of the blood pressure.

The debate on whether it is feasible to treat white coat syndrome still continues and there is no conclusive evidence that a rise in blood pressure while in a doctor’s office has actually any adverse health effects. However, perhaps this could be a signal that this person may eventually acquire a prehypertension or established hypertension with time.

There are cross-sectional studies which have indicated that target-organ damage is less in white coat hypertension. This is one of the reasons why doctors think that people with white coat hypertension should actually not be given even small doses of antihypertension therapy as this could lead to a condition known as hypotension. But the doctors on the other hand, are keen to note that this may also be a sign of an individual’s susceptibility and changes to vascular alterations, which could eventually lead to hypertension.

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Category: White Coat Hypertension

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