White Coat Hypertension may Indicate Heart Disease Risk in Some Older Adults

For some people, the blood pressure reading increases in a medical setting, but the reading becomes normal outside doctor’s office is termed as white coat hypertension.

White coat hypertension is a syndrome where patients have high blood pressures in a medical setting due to anxiety. But the blood pressure reading becomes normal outside the doctor’s office. White coat hypertension is not considered as a predictor of heart disease or stroke, but it could indicate disease risk in elderly, claims a new study.

White coat hypertension was identified more than three decades ago. It is a common condition that is a due to stress in a medical setting or in the presence of clinicians in ‘white coats.' Some studies have suggested white coat hypertension with health risks.

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Patients considered to have white coat hypertension actually have isolated systolic hypertension, which is an indicator of risk for heart disease or stroke.

Recent studies have shown that white coat hypertension is more common in older adults and the difference between the blood pressure readings in a medical setting and outside doctor’s office becomes larger with age.

Researchers from the University of California, Irvine, in collaboration with the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes, conducted the study to find out if white coat hypertension is an indicator of increased risk for heart disease.

The researchers used international hypertension database to analyze 653 patients with white coat hypertension and compared them to 653 patients of similar age and risk for developing heart disease.

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During a follow-up period of 10.6 years, the researchers found no difference in the number of new heart-related health events between people below the age 60 with normal blood pressure and those of a similar age with white coat hypertension. However, there was a difference in older patients. Out of 92 high-risk subjects with over 60 years of age, there were 18 more new cardiovascular events during the follow-up period for those diagnosed with white coat hypertension when compared to those of similar age and risk profile with normal blood pressure.

Lead researcher, Dr Stanley S. Franklin, said the results support the hypothesis that a small number of patients considered to have white coat hypertension actually have isolated systolic hypertension, a common condition where the top number in the blood pressure reading (systolic blood pressure) is too high, but the bottom number (the diastolic blood pressure) is normal. Isolated systolic hypertension can be an indicator of risk for future heart disease or stroke.

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The researchers concluded that multiple blood pressure reading, including readings outside a medical setting, are needed to accurately identify heart disease risk in high-risk older patients.

The study is published in the Journal of the American College of Cardiology.

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White-coat syndrome is an increase in blood pressure only in a clinical setting, due to a fear of doctors and needles. The symptoms include weight gain and increased risk of diabetes among others.

Source-Medindia