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White Coat Hypertension - What is It?

As defined by the medical dictionary, this term refers to an increase in blood pressure during a visit to the doctor's office and normal blood pressure at other times. For some people, simply being in a medical setting or having their blood pressure measured by a doctor causes their blood pressure to rise. The more comfortable and relaxed a person is with the clinical setting, the more likely the blood pressure readings in the office will be close to the blood pressure readings seen at home.

Experts disagree as to what levels of 24-hour blood pressure should be used to define white coat hypertension but almost everyone accepts that hypertension in the clinic should be defined by a cutoff point of 140/90 mm Hg.

White coat hypertension is relatively common. To detect it, one must measure the blood pressure both in the clinic repeatedly to establish that it is persistently high, and also away from the clinic. The diagnosis can most reliably be established by performing a 24-hour blood pressure recording using ambulatory monitoring, although the finding of persistently normal blood pressure at home as measured by the patient or family member certainly supports the diagnosis.

Blood pressure monitoring at home is simple and easy. Digital Blood Pressure Monitors start at around $30.00 retail and can be purchased at your local drug store. Keeping an accurate log or journal of the readings away from the clinic is an excellent way to help a physician either confirm or dispel whether or not a patient has white coat hypertension.

There are many reasons to identify white coat hypertension and to differentiate those patients whose blood pressures are only elevated in the doctor’s office and are normal at all other times. The most critical reason is to prevent unnecessary treatment of hypertension. If antihypertensive medication is prescribed to a person who only has elevated blood pressure in the clinic, then the treatment may cause low blood pressure at all other times, which may result in fatigue, light headedness and other side effects. It is also useful to identify whether blood pressure elevations are simply isolated to the doctor’s office, or whether they are present at other times as well, for example, at work.

It remains controversial whether white coat hypertension should be treated with antihypertensive medications, but any benefits of treatment are unproven.

Health Disclaimer: The content on this article is not intended to substitute for the advice of a qualified physician, pharmacist, or other licensed health-care professional. Contact your health-care provider immediately if you suspect that you have a medical problem.

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