Rule Out White-Coat Hypertension

Patients who experience a transitory spike in blood pressure (white-coat hypertension) during a doctor?s office visit should not be alarmed. In a study of 57 participants referred to a hypertension clinic, most people who had blood pressure readings of 200 mm/Hg or higher during an office visit actually had much lower blood pressure, according to a report presented last month at the Inter-American Society of Hypertension.

During the study, researchers followed participants whose average systolic blood pressure was at least 200 mm/Hg at office visits. When blood pressure was monitored throughout the day using a device worn on the body, the average systolic pressure was ~151 mm/Hg. Researcher Mihaly Tapolyai, MD, of the Cleve-land Clinic Florida, recommends monitoring patients for 24 hours who present with extremely high blood pressure before starting treatment. Treating white-coat hypertension without confirming that a person does indeed have high blood pressure may cause a person?s blood pressure to fall below normal, he warned.