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White-Coat Hypertension: Exam Room Jitters

For some patients, doctors provide the cause of, not the cure for, high blood pressure.

Fall 2010
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Year the Italian physician Scipione Riva-Rocci made the first known reference to patients experiencing heightened blood pressure after stepping into a clinical environment

Year the term “white-coat syndrome” was coined, when Italian physician Giuseppe Mancia and his colleagues reported in the journal Lancet that, on average, a patient’s heart rate and systolic and diastolic blood pressure rose significantly when a physician (hence the term “white coat”) entered the patient’s room

exam room jitters

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Percentage of the general population estimated to experience white-coat hypertension (now used synonymously with white-coat syndrome)

Minimum office blood pressure reading on at least three occasions, in addition to daytime ambulatory blood pressure measurements below 135/85, required for a white-coat hypertension diagnosis

Estimated percentage of patients diagnosed with sustained hypertension (which requires treatment) who, in fact, may only have white-coat hypertension (which usually doesn’t require treatment), according to the journal Circulation

Estimated cost savings in dollars over six years for one clinic that monitored ambulatory blood pressure in 255 hypertensive patients 24 hours a day to distinguish sustained hypertension from white-coat hypertension, and treated only the sustained hypertensives, according to a 1995 study in the European Heart Journal

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