Many doctors are aware that many patients find it stressful just to come in and see them.

“White-coat” high blood pressure is the informal name physicians use to label small jumps in blood pressure patients may have in the office but which wouldn’t show up in less stressful moments—-at home, for instance.

The sight of their white coats, they have believed, is enough to produce a jump in blood pressure for patients whose blood pressure is on the edge between normal and just over the line into too high—-”borderline” patients.

A new study in a American Heart Association journal shows that it likely that patients whose blood pressure readings are higher in the doctor’s office have what the authors call “masked hypertension.”

American Heart Association Recommendation:

AHA Recommendation

“High blood pressure, or hypertension, is defined in an adult as a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher. Blood pressure is measured in millimeters of mercury (mm Hg).

mm Hg = millimeters of mercury

High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack) and stroke, especially along with other risk factors.“

If the mere sight of your doctor is enough to cause your blood pressure to go up, discuss ways you can bring it down.

The doctor and the white coat are giving you valuable information which could help save your life. High blood pressure is called the “silent killer” for a good reason.

Medpage Today

“SAN FRANCISCO, June 29 — Whether it’s “white-coat” or “masked,” sporadic hypertension substantially increases risk of sustained hypertension, later in life, researchers found.

“Sustained hypertension risk after 10 years was two to three times higher in patients with so-called “white-coat” hypertension — which shows up in the doctor’s office but not at home or in other settings — than in patients with normal blood pressure.(Emphasis added)

“The risk of sustained high blood pressure was nearly twice as high in those with “masked” hypertension — which shows up at home but not in the doctor’s office — than in initially normotensive patients, Giuseppe Mancia, MD, of the University Milan-Bicocca in Milan, Italy, and colleagues reported.

“These longitudinal cohort study findings — published in Hypertension: Journal of the American Heart Association — add to the long-standing debate on whether sporadic elevations in blood pressure are clinically meaningful.”

“These results clearly indicate that neither of the two conditions should be shrugged off as innocent observations,” said Franz H. Messerli, MD, and Harikrishna Makani, MD, both of St Luke’s-Roosevelt Hospital Center and Columbia University in New York.”

Source: Medpage Today, June 29, 2009

Citation: Hypertension: Journal of the American Heart Association, Hypertension 2009; 54.