White Coat Hypertension

 White coat hypertension is also got another name for it that is a white coat syndrome. This is a phenomenon which is related with the stress that the patients feel while visiting a doctor.


In such cases a person who is having his/her blood pressure checked by a doctor and hence the co-relation with a white coat will have his blood pressure higher than normal. A clinical setting will have an impact on the reading when compared to a reading taken in other settings. This is due to the anxiety, fear of the uncertain and the trepidations that the patients feel on visit to a clinic.


The measurement of blood pressure can happen at several places and the readings might not be the same. Hence, the feeling of places that are stress and anxiety inducing can be quite subjective. When blood pressure is taken at night time or just before one gets out of bed they can be substantially low. Due to this there have been many a problem that has been encountered in actually diagnosing a white coat hypertension and the treatment to be followed for it.

There could be also a flip side to it such as masked hypertension which might be low in a clinic but high during the routine stress of living.


The conventional methods of recording high blood pressure do not really help much in the detection of this kind of hypertension. There are several problems and constraints to recording blood pressure. They are the variable factor of blood pressure based on where you are and what you are doing, the sphygmomanometers used are not up to the mark, the cuff used might be too small, the patient might be talking and so forth.


Patients who have white coat hypertension do not appear anxious or nervous on the outside. Up to 15 to 30% of people who are associated with mild hypertension at the clinic might have no hypertension outside. These patients do not show any specific signs or symptoms hence it becomes difficult to diagnose those with white coat hypertension.


In order to overcome white coat hypertension more and more patient self-measurement devices for home blood pressure measurements are being used. Ambulatory monitoring of hypertension is not without its own pitfalls too. They do have the variables to take care of such as physical activity, stressful situations and sleep patterns. Ambulatory monitoring has been found to be more effective in treating white coat hypertension. This could save the patient from organ damage which is life threatening and of course irreversible. Ambulatory monitoring can be quite expensive hence some doctors use breathing patterns to diagnose white coat hypertension. At the same time regular home tracking of hypertension recordings is quite convenient and economical. A research conducted has shown that almost 43% of hypertensive patients had white coat hypertension.


If your blood pressure recordings are going to be higher in front of your doctor than the treatment might be misdiagnosed or you might be given a higher dosage than necessary. This could be dangerous. For years doctors did not realize this and hence the treatment did not take this aspect into consideration.

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