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["White coat effect" on blood pressure]
1Unità Operativa di Medicina Interna, San Miniato (Pisa), Azienda USL 11, Empoli.
Insights
Ambulatory blood pressure monitoring reveals "white coat hypertension" and "white coat normotension" in nearly 20% of patients. These conditions, identified by comparing clinic and ambulatory readings, may alter treatment decisions for arterial hypertension.
Area of Science:
- Cardiology
- Hypertension Management
- Diagnostic Technologies
Background:
- Non-invasive ambulatory blood pressure monitoring (ABPM) is increasingly utilized for assessing arterial hypertension.
- The
- white coat effect
- describes discrepancies between clinic and ambulatory blood pressure readings.
Purpose of the Study:
- To highlight the prevalence and clinical significance of
- white coat hypertension
- and
- white coat normotension
- in patient populations.
- To emphasize the role of ABPM in differentiating these conditions.
Main Methods:
- Comparison of blood pressure measurements obtained in a clinical setting versus those recorded via ambulatory monitoring.
- Analysis of patient data to identify prevalence of discordant readings.
Main Results:
- Nearly 20% of unselected referred patients exhibit conditions related to the
- white coat effect
- .
- These include
- white coat hypertension
- (clinic hypertension, ambulatory normotension) and
- white coat normotension
- (clinic normotension, ambulatory hypertension).
Conclusions:
- The
- white coat effect
- impacts a significant portion of patients evaluated for hypertension.
- Identifying
- white coat hypertensives
- and
- white coat normotensives
- using ABPM is crucial for appropriate management and avoiding unnecessary or indicated antihypertensive therapy.
Abstract:
In the past few years non-invasive ambulatory blood pressure monitoring has become a widespread technology in the assessment of arterial hypertension. The "white coat effect" concept derives from comparison between "clinic" and "ambulatory" blood pressure. It consists of two opposite conditions: clinic hypertension with ambulatory normotension (the so-called "white coat hypertension") and clinic normotension with ambulatory hypertension (the so-called "white coat normotension"). Nearly 20% of unselected referred populations shows conditions that may not need medical treatment, such as the "white coat hypertensives", or that may need antihypertensive therapy, such as the "white coat normotensives".
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