Serum cortisol in the white-coat phenomenon

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Psychophysiology

Background:

• The 'white-coat phenomenon' describes elevated blood pressure in clinical settings, potentially due to anxiety or stress.
• Glucocorticoids are implicated in stress-induced blood pressure increases, but their specific role in the white-coat phenomenon is unclear.

Purpose of the Study:

• To investigate the relationship between the white-coat phenomenon and serum cortisol levels in young individuals with essential hypertension.

Main Methods:

• Compared 48 young hypertensive subjects with 12 normotensive controls.
• Measured home blood pressure for 7 days and serum cortisol at 0900h and 1100h.
• Calculated the white-coat phenomenon for systolic and diastolic blood pressure.

Main Results:

• Hypertensive subjects exhibited higher morning serum cortisol (0900h) than normotensive subjects.
• The magnitude of the white-coat phenomenon correlated with 0900h serum cortisol levels in hypertensive individuals.
• Morning cortisol levels in hypertensive subjects remained elevated over a 4-month period.

Conclusions:

• The white-coat phenomenon appears associated with transient increases in serum cortisol, indicating activation of the hypothalamic pituitary adrenocortical axis.
• Psychological stress or elevated cortisol, or both, may contribute to the white-coat phenomenon in essential hypertension.