Your blood pressure reads higher at a clinic than in other settings. Many thought white coat hypertension was simply stress or nerves, but a recent study suggests there may be more to it.
Dr. Richard Ammar says white coat hypertension for years was thought to be a case of someone nervous when seeing a physician. Their blood pressure would return to normal outside that environment.
“Several studies suggested just a benign process,” said the interventional cardiologist with Texas Health Allen. “This is really the first study where white coat hypertension is associated with higher mortality.”
Ammar says the study suggests someone with white coat hypertension might benefit from 24-hour monitoring of blood pressure outside a clinic. But he adds that requires a quality blood pressure monitor (not the cuff or finger type you’d find at a drug store), and that any outside monitoring should be done in conjunction with a physician.
About the study: It was initially designed to give us an idea about the value of monitoring blood pressure over the course of an entire day. Every single person in the study had a 24-hour blood pressure monitor applied by the investigators. And they were grouped into people with normal blood pressure, people with white coat hypertension, then people with sustained hypertension (their blood pressure’s high all the time), and people with “masked" hypertension (their blood pressure’s normal in the clinic, but elevated outside.) The investigators then observed how they did with regards to mortality, who showed up in the rolls as deceased.
On 24-hour monitoring: I would say it is valuable to be monitored at least some outside of a clinical setting and to react to the blood pressure reading in conjunction with a patient’s physician. Blood pressure may vary, in a normal person, from something like 100 over 60 up to 160 over 90 over the course of a day. No single reading is as valuable as many of them. More or less the average is what’s important.
White coat hypertension as cause for concern: The study suggests a person who has it might in fact be a good candidate for 24-hour monitoring and certainly additional readings. The study did not talk about what to do about it. It only said this is no longer a benign condition; it is something we need to pay attention to. But this will be the subject of studies over the next several years.
On hypertension (high blood pressure): It is probably the most preventable cause of early death and cardiovascular death that there is. Almost in every person with high blood pressure it can come under control with a regimen that a person can tolerate very well.