High blood pressure (hypertension)

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  • With Mayo Clinic emeritus hypertension specialist

    Sheldon G. Sheps, M.D.

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Question

White-coat hypertension: When blood pressure rises at the doctor's office

My blood pressure is always higher in the doctor's office than when I measure it at home. Why is this?

Answer

from Sheldon G. Sheps, M.D.

You could have "white-coat hypertension." White-coat hypertension occurs when the blood pressure readings you have measured at your doctor's office are higher than they are when measured in other settings, such as your home. It's called white-coat hypertension because the health care professionals who measure your blood pressure sometimes wear white coats.

It was thought that white-coat hypertension is caused by the stress that doctor's appointments can create. Once you'd left the doctor's office, if your blood pressure normalized, there wasn't a problem.

However, doctors now think that white-coat hypertension might signal that you're at risk of developing high blood pressure as a long-term condition. The same may also be true for people who have masked hypertension, meaning their blood pressure is normal at the doctor's office, but spikes periodically when measured in other settings. It's thought that even temporary increases in your blood pressure could develop into a long-term problem.

If you have white-coat hypertension, talk to your doctor about home monitoring of your condition. This can help determine if your high blood pressure only occurs in the doctor's office, or if it's a persistent condition that needs treatment.

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References
  1. Mancia G, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226.
  2. Chung I, et al. White-coat hypertension: Not so benign after all? Journal of Human Hypertension. 2005;17:807.
  3. Kaplan NM. Ambulatory blood pressure monitoring and white coat hypertension in adults. http://www.uptodate.com/home/index.html. Accessed July 9, 2009.

AN02014

Aug. 27, 2009

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