[Office hypertension--early stage of hypertension. Epidemiology, causes and consequences]

The prevalence of office hypertension is approximately 20-25% of all untreated "hypertensives" identified in the doctor's office, i.e. in Germany some 3 million patients. During the following years a considerable proportion (50-75%) of patients with office hypertension will develop established hypertension. Office or white coat hypertension seems to represent a frequent prehypertensive state. Compared to normotensive controls patients with office hypertension exhibit abnormal regulation of systolic and diastolic blood pressure with a steeper early morning rise and a deeper nocturnal fall leading to a greater blood pressure amplitude (amplitude hypertension). Furthermore patients with office hypertension have functional cardiovascular abnormalities. The hemodynamic, functional and biochemical findings indicate abnormal baroreceptor sensitivity and increased sympathetic tone during the day. Office hypertension cannot be considered to be an innocent blood pressure variant. The identification of patients with office hypertension is of diagnostic, prognostic and therapeutic significance.