Author:
Townsend Raymond R.,Cohen Jordana B.
Abstract
Abstract
Purpose of Review
This review aims to inform the reader of the complexity of blood pressure responses when comparing blood pressure measured in the medical environment to that outside the medical environment. In addition, we summarize what is known about current predictors of white coat hypertension, reevaluate the relationship of white coat hypertension to cardiovascular outcomes, and provide some clinical guidance on management.
Recent Findings
Differences in outcomes exist when white coat effect occurs in unmedicated people versus the white coat effects in those on antihypertensive therapy.
Summary
White coat hypertension is relatively common, carries a small but definite increase in cardiovascular risk, and is prone to conversion to sustained hypertension. Future research will hopefully tease out the roles of ancillary findings that characterize a white coat hypertensive (like modest elevations in creatinine, glucose and triglycerides) in the elevated cardiovascular risk, and test the effectiveness of mitigation strategies in these patients.
Publisher
Springer Science and Business Media LLC
Reference56 articles.
1. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13–115.
2. Muntner P, Carey RM, Jamerson K, Wright JT Jr, Whelton PK. Rationale for Ambulatory and Home Blood Pressure Monitoring Thresholds in the 2017 American College of Cardiology/American Heart Association Guideline. Hypertension. 2019;73(1):33–8.
3. Barochiner J, Aparicio LS, Alfie J, Cuffaro PE, Marin MJ, Morales MS, et al. Alerting Reaction in Office Blood Pressure and Target Organ Damage: An Innocent Phenomenon? Curr Hypertens Rev. 2017;13(2):104–8.
4. • Mancia G, Bertinieri G, Grassi G, Parati G, Pomidossi G, Ferrari A, et al. Effects of blood-pressure measurement by the doctor on patient’s blood pressure and heart rate. Lancet. 1983;2(8352):695–8. A classic paper, not likely to be repeated.
5. Mancia G, Parati G, Pomidossi G, Grassi G, Casadei R, Zanchetti A. Alerting reaction and the rise in blood pressure during measurement by physician and nurse. Hypertension. 1987;9:209–15.