“White Coat Hypertension” Doubles Heart Disease Mortality Risk

High blood pressure is a common symptom to a handful of other conditions that can be serious or benign.  However, new research suggests that if blood pressure spikes occur between home testing and clinical testing, it could be the sign of something quite serious. 

Known as “white coat hypertension,” high blood pressure at the doctor’s office (with stable levels at home) might put a person at double the risk for heart disease death than patients with normal blood pressure, especially without hypertension medication interventions.

Blood pressure, of course, is a numerical measurement of the force required for the heart to push blood flow through the veins, arteries, and capillaries.  This pumping is considered too high if the numbers are above 130/90.  The top number is the systolic pressure and it reflects pressure in the blood vessels during a heartbeat. The bottom number is the diastolic pressure and it reflects pressure when the heart is at rest.  

With all this research, doctors are still uncertain the cause of white coat hypertension.  As a matter of fact, the present understanding is that it could have different triggers in different patients.  For example, some people might experience this anomaly as a result of anxiety, which can cause blood pressure to rise in a medical setting.  In other patients, blood pressure fluctuations might be related to different underlying physical or psychological conditions. 

Although identifying this condition has been a somewhat recent development, researchers believe as many as 1 in 5 American adults might experience white coat hypertension.  To discern this ratio, Penn Medicine researchers analyzed the results of 27 studies that involved more than 64,000 patients across Asia, Europe, and the United States.  Sure enough, the consistent findings among those with white coat hypertension suggest they are at a definitely elevated risk for cardiovascular events—including death—than those with normal blood pressure. 

At the end of the day, then, lead study author Jordan B. Cohen, MD, MSCE comments, “Our findings underscore the importance of identifying people with this condition.”

The Penn Medicine Renal-Electrolyte and Hypertension professor and Center for Clinical Epidemiology and Biostatistics senior scholar goes on to say, “We believe individuals with isolated in-officer hypertension—those who are not taking blood pressure medication—should be closely monitored for transition to sustained hypertension, or elevated blood pressure both at home and the doctor’s office.”

The results of this meta-analysis was published in the journal Annals of Internal Medicine, on Monday. 

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