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Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Special considerations while measuring blood pressure01:28

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When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
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Measurement of Blood Pressure01:17

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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Decoding white coat hypertension.

Dennis A Bloomfield1, Alex Park1

  • 1Dennis A Bloomfield, Alex Park, Richmond University Medical Center, New York, NY 10310, United States.

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|March 30, 2017
PubMed
Summary

The "white coat" effect in hypertension involves elevated blood pressure readings due to medical anxiety. Cardiovascular risk is linked to higher nighttime pressure, not the "white coat" phenomenon itself.

Keywords:
Ambulatory blood pressureConditioned reflexHypertensionMorning surgeNeuro-endocrine reflexNighttime dipTriggersWhite coat

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Area of Science:

  • Cardiology
  • Hypertension Research
  • Neuroendocrinology

Background:

  • The
  • White coat hypertension (WCH) is a poorly understood phenomenon where blood pressure readings are higher when taken by medical professionals compared to self-measurement.
  • The standard concept of WCH involves elevated readings by authoritative personnel versus junior staff or self-monitoring.

Purpose of the Study:

  • To investigate the characteristics and implications of the white coat phenomenon in hypertension.
  • To differentiate between the white coat effect and actual cardiovascular risk factors.

Main Methods:

  • Hospital-initiated ambulatory blood pressure monitoring (ABPM).
  • Analysis of blood pressure profiles, including daytime and nighttime readings, in treated and untreated patients.
  • Evaluation of systolic and diastolic pressure variations.

Main Results:

  • The white coat effect primarily manifests as systolic pressure elevations, with pure diastolic WCH being rare.
  • In treated patients, WCH can present as a low daytime blood pressure profile.
  • Blunting of the nighttime blood pressure dip in treated patients may be a compensatory mechanism, not a cardiovascular risk indicator.

Conclusions:

  • The white coat phenomenon is a common, periodic neuro-endocrine reflex triggered by the anticipation and fear associated with blood pressure measurement.
  • WCH does not typically change over time or with prolonged physician association.
  • Cardiovascular risk is associated with elevated average nighttime blood pressure, rather than blunted nighttime dips, morning surges, or widened pulse pressure.