White coat hypertension
White coat hypertension is a form of resistant hypertension in which the blood pressure is elevated when checked in the medical office but may be normal with ambulatory blood pressure monitoring.
White coat hypertension may be associated with:[1]
- "parallels the reactivity to mental stress and standing in hypertensive subjects"
- "likely results from a sympathetic nervous activation via a vasoconstrictor response rather than tachycardia"
- "decreased arterial distensibility"
White coat hypertension may be associate with anxiety (at least in women)[2], obstructive sleep apnea, and metabolic syndrome.
Although most patients with white coat hypertension are males, a greater proportion of women with hypertension have white coat hypertension than males with hypertension.[3]
Treatment
Because of the association with metabolic syndrome, one treatment option is metformin.[4]
Prognosis
White coat hypertension may evolve into sustained hypertension.[5][6]
Cardiovascular risks were not increased in one study with 10 years of follow-up.[7]
References
- ↑ Lantelme P, Milon H, Gharib C, Gayet C, Fortrat JO (1998). "White coat effect and reactivity to stress: cardiovascular and autonomic nervous system responses.". Hypertension 31 (4): 1021-9. PMID 9535430. [e]
- ↑ Carels RA, Sherwood A, Blumenthal JA (1998). "High anxiety and white coat hypertension.". JAMA 279 (3): 197-8. DOI:10.1001/jama.279.3.197. PMID 9438737. Research Blogging.
- ↑ Pickering TG, James GD, Boddie C, Harshfield GA, Blank S, Laragh JH (1988). "How common is white coat hypertension?". JAMA 259 (2): 225-8. DOI:10.1001/jama.1988.03720020027031. PMID 3336140. Research Blogging.
- ↑ Helvaci MR, Sevinc A, Camci C, Yalcin A (2008). "Treatment of white coat hypertension with metformin.". Int Heart J 49 (6): 671-9. PMID 19075483. [e]
- ↑ Ugajin T, Hozawa A, Ohkubo T, Asayama K, Kikuya M, Obara T et al. (2005). "White-coat hypertension as a risk factor for the development of home hypertension: the Ohasama study.". Arch Intern Med 165 (13): 1541-6. DOI:10.1001/archinte.165.13.1541. PMID 16009871. Research Blogging.
- ↑ Bidlingmeyer I, Burnier M, Bidlingmeyer M, Waeber B, Brunner HR (1996). "Isolated office hypertension: a prehypertensive state?". J Hypertens 14 (3): 327-332. PMID 8723986. [e]
- ↑ Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J et al. (2005). "Prognosis of "masked" hypertension and "white-coat" hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study.". J Am Coll Cardiol 46 (3): 508-15. DOI:10.1016/j.jacc.2005.03.070. PMID 16053966. Research Blogging.