Survey of white coat hypertension

BMJ 1999;318:535 ( 20 February )

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Survey of white coat hypertension

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EDITOR $---$ Muscholl et al reported that patients with white coat hypertension showed evidence of target organ damage as manifestedby changes in left ventricular structure and function when comparedwith normotensive subjects.¹ Though interesting, their resultsaremisleading.

The conventional method for identifying patients with white coat hypertension is by comparing blood pressure measured by aphysician in a clinic with measurements made with 24 hour ambulatorymonitors. Although there is no agreement as to the exact criteria,the central concept of white coat hypertension is that it is characterisedby high blood pressure only in the medical setting; blood pressureis normal at other times. In Muscholl et al's study, all the bloodpressure measurements were made in a medical setting. After atleast 30 minutes' rest, blood pressure was measured three timesby a technician, and the means of the second and third readingswere used as the baseline . . . [Full text of this article]

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Changes in left ventricular structure and function in patients with white coat hypertension: cross sectional survey: Michael W Muscholl, Hans-W Hense, Ulrich Bröckel, Angela Döring, Günter A J Riegger, and Heribert Schunkert
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