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[Blood pressure monitoring: dangers and traps]
G Rorive1, B Dubois, A Saint-Remy
1Service de Néphrologie-Hypertension, CHU Sart Tilman.
Insights
White coat hypertension, a condition of high blood pressure in medical settings but normal outside, does not increase cardiovascular risks and requires no drug treatment. However, one-third of patients may develop severe hypertension over time.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Medicine
Background:
- Blood pressure measurement is a common yet often unreliable medical procedure.
- Ambulatory blood pressure monitoring has improved the understanding of the 'white coat effect'.
Observation:
- White coat hypertension is characterized by elevated blood pressure in clinical settings and normal readings outside.
- This condition is distinct from sustained hypertension.
Findings:
- White coat hypertension is not linked to increased cardiovascular morbidity or mortality.
- It does not warrant pharmacological intervention.
Implications:
- A significant proportion (one-third) of individuals with white coat hypertension may progress to sustained hypertension.
- Regular monitoring is crucial for patients diagnosed with white coat hypertension to detect potential progression.
Abstract:
The measure of blood pressure is probably the the most frequently performed medical act, and the less reliable. The introduction of non invasive recording of ambulatory blood pressure allowed to better define the white coat effect, that is the effect of the presence of a doctor on the blood pressure. White coat hypertension is defined as an abnormal blood pressure in the office and a strictly normal blood pressure outside the medical environment. As such, white coat hypertension is not associated with an increase of cardiovascular morbidity and mortality and thus does not justify drug therapy. However, one third of the patients will progress with time to more severe stages of hypertension.