Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2017; 5(3): 82-92
Published online Mar 16, 2017. doi: 10.12998/wjcc.v5.i3.82
Published online Mar 16, 2017. doi: 10.12998/wjcc.v5.i3.82
Decoding white coat hypertension
Dennis A Bloomfield, Alex Park, Richmond University Medical Center, New York, NY 10310, United States
Author contributions: Bloomfield DA and Park A contributed equally to this work.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors who contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dennis A Bloomfield, MD, Director of Research, Richmond University Medical Center, 355 Bard Avenue, Staten Island, New York, NY 10310, United States. dbloomfield@rumcsi.org
Telephone: +1-718-8182707 Fax: +1-718-8181279
Received: July 14, 2016
Peer-review started: July 18, 2016
First decision: September 30, 2016
Revised: October 13, 2016
Accepted: December 1, 2016
Article in press: December 3, 2016
Published online: March 16, 2017
Peer-review started: July 18, 2016
First decision: September 30, 2016
Revised: October 13, 2016
Accepted: December 1, 2016
Article in press: December 3, 2016
Published online: March 16, 2017
Core Tip
Core tip: White coat hypertension is a poorly understood and significantly common ambulatory blood pressure finding. This study defines blood pressure during various periods of the day and night, analyzes nighttime dip and morning surge, provides insight into the triggers of the episode, and discusses the possible neuro-endocrine causes. It is a permanently conditioned reflex from anticipation and fear that blood pressure measurement may indicate future illness. Recognition of this condition reduces the patient’s worry, relieves them both of a lifetime of unnecessary medication and the side effects of the otherwise ever-increasing dosages, and diminishes the frustration of the attending physician.