PMID: 9534282Apr 16, 1998Paper

The difference between clinical ambulatory measured blood pressure and daily monitored pressure does not reflect the "white coat effect"

Cardiologia : bollettino della Società italiana di cardiologia
C SantucciuG Mancia

Abstract

The difference between clinic and average daytime ambulatory blood pressure is frequently used to identify patients with "white coat" hypertension (i.e. with a pronounced pressor response to the clinical evaluation) although there is no evidence that this difference is indeed due to a white coat effect. In 28 mild hypertensive outpatients, the blood pressure was continuously recorded by a noninvasive finger device before and during the doctor's visit. The peak blood pressure increase, recorded during the visit was compared with the difference between clinic and daytime average ambulatory blood pressure. Peak increases in systolic and diastolic finger blood pressure during the doctor's visit were 38.2 +/- 3.1 mmHg and 20.7 +/- 1.6 mmHg, respectively compared to pre visit values (means +/- standard error, both p < 0.01). Daytime average systolic and diastolic blood pressure were 135.5 +/- 2.5 mmHg and 89.2 +/- 1.9 mmHg, both being lower than the corresponding clinic blood pressure values (146.6 +/- 3.6 mmHg and 94.9 +/- 2.2 mmHg, p < 0.01). Their differences, however, were < 30% of the peak finger blood pressure increase during the physician's visit. While the physician's visit was associated with tachycardia (+9.0 +/- 1.6 b/min,...Continue Reading

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