White-Coat Hypertension and Carotid Artery Atherosclerosis

Open Access
Publisher Website
Google Scholar
Abstract
PHYSICIANS and, increasingly, the public are widely aware of the propensity of some persons to manifest hypertension in the office yet have normal blood pressure (BP) elsewhere. Labeled as exhibiting "white-coat hypertension," such individuals do not necessarily report anxiety surrounding clinic visits or during normal daily activities.1 Nonetheless, such situational BP elevations are generally understood to represent classic stress responses. In any case, physicians still struggle to understand the importance of white-coat hypertension and remain uncertain as to the best measure of BP to (1) establish a patient's risk for stroke, heart attack, congestive heart failure, and hypertensive renal disease and (2) guide antihypertensive treatment. Are high office readings in such patients diagnostic errors, or are individuals with white-coat hypertension at elevated risk for vascular disease events?