Healthcare Blog

Third Of Patients With Resistant Hypertension Have 'White Coat' Syndrome Instead, Says Study, UK

June 07, 2017

A new study suggests a third of patients thought to have resistant hypertension actually have 'white coat' syndrome - where their blood pressure is raised temporarily because they are nervous about visiting their doctor.

The study found that when a third of these patients recorded their blood pressure at home instead, they recorded normal levels proving their medication was in fact working for them.

Ellen Mason, senior cardiac nurse at the British Heart Foundation, said: "High blood pressure increases the risk of having a heart attack or stroke and so treating high blood pressure, whether through lifestyle changes or medication, is vital.

"This study looked at a minority of people who still had high blood pressure despite being on at least three drugs to treat it. Visiting the doctor seemed to make some people falsely appear resistant to the effects of these drugs so the study was helpful in trying to identify which people seemed to be truly resistant and therefore more at risk of organ damage.

"It also adds weight to new draft guidelines to include a home blood pressure test for hypertensive patients here in the UK.

"More worryingly though, nearly half of us who do have high blood pressure in the UK are not being treated for it. While the increasing use of home blood pressure monitoring is helpful for some, it will not target those who are unaware of the silent condition because it may have been many years since they had their blood pressure taken or because they simply think they are not at risk."

The National Institute for Clinical Excellence (NICE) has proposed that people with two high blood pressure readings should take a third at home to rule out 'white coat' syndrome in draft guidance currently being consulted on.

Notes Statement issued in response to study: "Clinical Features Of 8295 Patients With Resistant Hypertension Classified On The Basis Of Ambulatory Blood Pressure Monitoring" by Alejandro de la Sierra et al. Published in Hypertension: Journal of the American Heart Association. Hypertension/2010/168948 [R2] on March 28 2011.

British Heart Foundation