Those include white-coat hypertension
, peripheral amplification with normal central blood pressure, hyperadrenergic state, isolated systolic hypertension, and a smaller subset with secondary hypertension.
Factors affecting BP through stress include white-coat hypertension
, job strain, race, social environment, and emotional distress.
Chronic hypertension is one of the categories of the hypertensive disorders of pregnancy (HDP), the others being gestational hypertension, white-coat hypertension
and pre-eclampsia, which may be de novo or superimposed on chronic hypertension, eclampsia, and haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome.
Home monitoring combined with doctor visits to measure a patient's blood pressure helps to avoid numbers skewed by "white-coat hypertension
," when blood pressure is high in a medical setting but not in everyday life, and "masked hypertension," when blood pressure is normal in a medical setting but high at home.
The correlations for blood pressure with all-cause and cardiovascular mortality were assessed for sustained hypertension, white-coat hypertension
, masked hypertension, and normotension.
The blood pressure should be taken under non-stressful conditions (but dam#@* seeing a doctor is stressful enough!), usually meaning "rest, sitting, empty bladder, comfortable temperature." We must take note in fact of "white-coat hypertension
" which is "increases in blood pressure associated with the stress of physician office visits."
Ambulatory blood pressure monitors is anticipated to be the fastest growing segment in the device type segment, due to the effective use in the the diagnosis of white-coat hypertension
and masked hypertension.
This backs up previous research showing that up to one-third of patients have white-coat hypertension
, which falls to normal levels in other settings.
Some have suggested that an ABPM be reserved for detecting white-coat hypertension
or when there is concern for resistant hypertension.
(2) The US Preventive Services Task Force recommends the use of ambulatory blood pressure monitoring (ABPM) to accurately diagnose hypertension in all patients, while The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends ABPM for patients suspected of having white-coat hypertension
and any patient with resistant hypertension, (3,4) but ABPM is not always acceptable to patients.
: new insights from recent studies.
This may also be helpful for patients with 'white-coat hypertension
' who may have elevated blood pressure readings in physicians' offices but normal readings at home or in other settings."