The Article in Brief

Comparing the Effects of White Coat Hypertension and Sustained Hypertension on Mortality in a UK Primary Care Setting

Martin G. Dawes , and colleagues

Background Blood pressure measurements are of major importance, but they can be unreliable. Some patients have normal blood pressure when measured over time through a process called ambulatory blood pressure monitoring but high blood pressure when measured in the doctor's office (referred to as white coat hypertension). This study examines death rates in patients with white coat hypertension and compares them with those whose blood pressure is high in both the clinic and through ambulatory blood pressure monitoring.

What This Study Found White coat hypertension carries significantly less risk of death than if the patient has high blood pressure in both the clinic and when measured by ambulatory blood pressure monitoring.

Implications

• The authors suggest the medical community consider whether to stop using office blood pressure measurements for routine screening and diagnosing high blood pressure.
• Research is needed to evaluate how much risk can be reduced in patients with white coat hypertension who are treated with blood pressure-lowering therapy.