‘White Coat’ and ‘Masked’ hypertension linked to heart, vascular disease

Patients whose blood pressure spikes in the doctor’s office
but not at home and, conversely, patients whose blood pressure spikes at home but not in the doctor’s office suffer more heart attacks, heart failure, and strokes than patients with normal blood pressure in both settings, according to UT Southwestern researchers who studied more than 3,000 Dallas County residents for nine years.

“Previous studies on white coat hypertension—blood pressure that is high in a medical setting but normal at home—have shown conflicting results, and many
in the medical community have viewed it as a benign condition,” says the study’s leader, Wanpen Vongpatanasin, M.D. “Our research suggests, however, that white coat hypertension is associated with an increase in heart and vascular disease.”

Results were similar for patients with a condition called “masked hypertension,” which is the reverse of white coat hypertension—normal blood pressure in their physician’s office but high readings
at home.

Dr. Vongpatanasin notes that white coat hypertension is likely caused by anxiety in the medical setting while masked hypertension may be caused by stress in the home setting or by patients not being consistent about taking medications until a doctor’s visit is imminent.

Interestingly, the findings suggested that masked hypertension is more common than generally believed, with almost one in five participants recording elevated blood pressure only at home.

“Given the
high prevalence of masked hypertension in this population, our study supports the routine use of home blood pressure monitoring for U.S. adults—both for those who are taking antihypertensive drugs as well as those who are not,” Dr. Vongpatanasin says.

To make an appointment with a
 UT Southwestern hypertension specialist, call 214-645-8300.