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Rethinking "White-Coat Hypertension"

Someone who usually has normal blood pressure goes the doctor and the person's blood pressure zooms.  This phenomenon is known as "white-coat hypertension" (WCH for short), and the presumed cause is an adrenalin discharge in the presence of an authority figure in a long, white coat. 

Even though white-coat hypertension isn't an illness itself, recent research suggests that it may be cause for concern. Many studies comparing people with WCH to people with normal in-office blood pressure have shown subtle findings that may portend trouble. 

Here are some of the findings:

* Studies following WCH patients have found that, over time, the number of strokes and heart attacks they experience begin to resemble the rates seen in patients with sustained hypertension.

* People with WCH are more likely to be obese and have higher blood triglycerides (a fat linked to heart attacks) and insulin levels (a possible forerunner of type 2 diabetes).

* A Japanese study found that those with WCH had twice the risk of developing true hypertension within eight years.

"I have come to regard white-coat hypertension as a way station between normal blood pressure and hypertension," writes Marvin M. Lipman, M.D., Consumers Union's chief medical adviser in the April issue of Consumer Reports on Health

Lacking solid evidence that treatment with antihypertensive drugs will stay the course of WCH, Dr. Lipman keeps a close eye on patients who have the condition, sometimes advising them to lose weight if appropriate, cut back on salt, and exercise.



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