Intended for healthcare professionals


Survey of white coat hypertension

BMJ 1999; 318 doi: (Published 20 February 1999) Cite this as: BMJ 1999;318:535

Definition differs from others

  1. Kazuomi Kario, Visiting fellow,
  2. Thomas G Pickering, Professor of medicine (
  1. Hypertension Center, Department of Medicine, Cornell University Medical CollegeThe New York Hospital, New York, NY 10021, USA
  2. Institut für Epidemiologie und Sozialmedizin, University of Münster, Münster, Germany
  3. Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Regensburg, Germany

    EDITOR—Muscholl et al reported that patients with white coat hypertension showed evidenceof target organ damage as manifested by changes in left ventricular structure and function when compared with normotensive subjects.1 Though interesting, their results are misleading.

    The conventional method for identifying patients with white coat hypertension is by comparing blood pressure measured by a physician in a clinic with measurements made with 24 hour ambulatory monitors. Although there is no agreement as to the exact criteria, the central concept of white coat hypertension is that it is characterised by high blood pressure only in the medical setting; blood pressure is normal at other times. In Muscholl et al's study, all the blood pressure measurements were made in a medical setting. After at least 30 minutes' rest, blood pressure was measured three times by a technician, and the means of the second and third readings were …

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