Mental arithmetic is a useful diagnostic evaluation in white coat hypertension

Area of Science:

• Cardiology
• Hypertension Research
• Psychophysiology

Background:

• White coat hypertension (WCH) is characterized by elevated blood pressure in clinical settings but normal readings outside.
• The susceptibility of WCH patients to mental stress compared to essential hypertension (EH) patients is not well-established.
• Understanding stress responses is crucial for comprehensive hypertension management.

Purpose of the Study:

• To compare the pressor responses to mental arithmetic stress between patients with WCH and EH.
• To investigate if mental stress testing can differentiate between WCH and EH.
• To assess the role of mental stress in the pathophysiology of WCH.

Main Methods:

• Study included 21 untreated female outpatients (aged 42-64 years) with hypertension.
• Patients were categorized into WCH (n=11) and EH (n=10) groups after 2 weeks of self-monitoring blood pressure.
• Blood pressure responses to a standardized mental arithmetic test were measured and compared between groups, controlling for age and baseline blood pressure.

Main Results:

• Patients with WCH exhibited significantly greater systolic and diastolic blood pressure increases during mental arithmetic testing (+38/+24 mm Hg) compared to EH patients (+21/+13 mm Hg).
• These differences remained statistically significant after adjusting for age and baseline blood pressure.
• The findings indicate a heightened pressor response to mental stress in WCH.

Conclusions:

• Patients diagnosed with white coat hypertension demonstrate a more pronounced blood pressure reactivity to mental stress compared to those with essential hypertension.
• Mental arithmetic testing may serve as a valuable diagnostic tool to identify individuals with white coat hypertension.
• Further research should explore the long-term cardiovascular implications of this heightened stress response in WCH.