White Coat Hypertension
White coat hypertension is a phenomenon that has not been fully elucidated, although it is hypothesized that stress is the trigger. It involves an increase in blood pressure levels, but only temporarily.
White coat hypertension is a condition in which the blood pressure rises when the person is in a doctor’s office or hospital. On the other hand, if you are at home or in a neutral place, it presents normal indices.
Contrary to what one might think, it is a very widespread phenomenon. It is estimated that between 25 and 35% of those who have high blood pressure in an office, actually correspond to cases of the white coat.
In principle, this type of disorder is due to an anxious reaction. However, in some cases there may be a more serious problem. On the other hand, the opposite is also possible: a person who is regularly hypertensive shows normal values in the office. In that case we speak of masked hypertension .
Causes of white coat hypertension
Most commonly, white coat hypertension is the effect of anxiety caused by doctors or healthcare environments in some people. That kind of additional stress leads to values rising temporarily.
There are people who can also have hypertension momentarily for other reasons. For example, an adverse situation, the consumption of foods high in sodium or the ingestion of caffeine.
The point is that while blood pressure returns to normal, it cannot be ruled out that there is something deeper. In general, people with white coat hypertension do not require drug treatment, but they do need to be monitored.
Based on the available data, this disorder could be associated with an increased risk of adverse cardiovascular events. A study carried out by Gabriel Alcalá Sierra indicated that 46.9% of those with this condition developed essential hypertension within 8 years.
How to determine if hypertension is real?
Determining whether a person has essential or white coat hypertension is crucial for medical follow-up and treatment of the disease . To achieve this, there are two tools: ambulatory measurement and home self-measurement. Let’s see what each one consists of.
Outpatient measurement
The first alternative is to use an ambulatory blood pressure monitor. This device is provided by the doctor and should be tied around the waist for 24 to 48 hours. The device performs a measurement every 20 or 30 minutes and in this way it is possible to closely monitor variations.
In this case as well as in the next, at the end an average must be taken between all the recorded figures. This is the average of the arterial pressure and allows to establish if there is hypertension of the white coat, masked or real.
Home self-measurement
It consists of taking regular measurements of blood pressure indices in non-medical settings. To do this, you must purchase a home blood pressure monitor. It is very important that the machine is reliable and that the procedure is very clear.
It is advisable to do the measurement for seven continuous days, twice a day: in the morning and at the beginning of the night. Half an hour before measuring pressure levels, nothing should be done to raise it, such as physical activity or eating certain foods.
Tips to overcome white coat hypertension
White coat hypertension is the subject of debate in the medical world. While some experts consider it to be associated with an increased cardiovascular risk, others believe that most events occur in elderly people, so the true risk factor is age.
At the moment there are no definitive conclusions. When in doubt, it is best to take precautions. The first one is to confirm the diagnosis through the methods already described. If it is confirmed, it is convenient to work on stress through relaxation techniques or psychological consultation.
It is also advisable to cultivate more adaptive behaviors in front of the medical consultation. It might be a good idea to move away from the more congested areas of the hospital or office and ask for some time if there is a lot of stress at the time of measurement. Likewise, it is convenient to have a cardiovascular checkup on a regular basis.
A type of hypertension that can hide other problems
It is assumed that most patients have a higher blood pressure level during consultation. The usual thing, in any case, is that a definitive diagnosis is not made only based on a sporadic reading.
If essential hypertension is suspected, it is best to verify the figures by ambulatory measurement or home self-measurement. No matter what the cause or the modality is, when the blood pressure presents abnormal values, it is always necessary to follow up.
