American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

Letters to the Editor

From the January ACP Internist, copyright 2013 by the American College of Physicians

White coat hypertension

Your recent article on white coat hypertension (“White coat hypertension presents an elusive challenge,” ACP Internist, October 2012) offers the opportunity to raise two issues that have nagged me over the years.

First, if a patient’s blood pressure rises as a stress response to being examined by a physician, could this signify that the patient might indeed spend a good part of the day with elevated blood pressure if he works a stressful job and drinks a lot of caffeine? And if the “gold standard” is a quiet, resting blood pressure reading in the morning, to what extent would that disagree with a 24-hour reading in this patient?

Second, I would venture to say that much of the research on hypertension was conducted using readings taken by physicians and nurses wearing white coats. To what extent is “white coat hypertension” baked into the studies upon which we depend?

Richard Gayes, MD, ACP Member
Oak Park, Ill.

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

ACP Clinical Shorts

Expert Education on Your Schedule

Short videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-goShort videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-go. See more.

New: Free Modules from ACP Practice Advisor!

New: Free Modules from ACP Practice Advisor!

Keep your practice moving in the right direction. ACP Practice Advisor is offering four modules that you and your staff can try for free. Get to know the premier online practice management tool at no risk. Explore the modules.