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White Coat Hypertension
News and Research:
Doctors raise blood pressure in patients - Science Daily, 3/25/14 -
"recordings taken by doctors are significantly
higher (by 7/4mmHg) than when the same patients are tested by nurses"
White Coat Hypertension
in the Very Elderly: Worth Treating? - Medscape, 2/28/13 -
"We should not ignore patients who say that their
blood pressures at home are not high, so we do not need to treat them,
because white coat hypertensives in this elderly age group benefited just as
much as people who had ambulatory monitoring elevations"
'White Coat Effect' Linked to Hypertension Overtreatment - WebMD, 6/21/11 -
"the stress of a medical exam can cause large elevations
in blood pressure ... the new research highlights the largely unrecognized risk
of treating patients too aggressively based on falsely high blood pressure
Treatment of white coat hypertension with metformin - Int Heart J. 2008
Nov;49(6):671-9 - "White coat hypertension (WCH) is
most likely a disorder associated with metabolic syndrome ... Twenty-five
cases (14.7%) stopped metformin therapy due to excessive anorexia. At the
end of a 6-month period, there were highly significant differences between
the two groups with respect to the prevalences of resolved WCH,
hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, overweight and
obesity, and decreased fasting plasma glucose below 110 mg/dL ... Thus, the
management of WCH should not focus solely on the regulation of blood
pressure with antihypertensive medications, but rather on the prevention of
future excess weight and various associated disorders, and metformin alone
is an effective therapeutic option, most likely due to its powerful
inhibitory effect on appetite"
blood pressure measurements taken in the physician's office avoid the 'white
coat' bias? - Blood Press Monit. 2011 Sep 3 -
"physician's clinic (CBP) ... ambulatory (ABP) and home (HBP) monitoring ...
nonclinical setting by trained technicians (NCBP) ... Multiple regression
analysis showed that HBP and NCBP (P<0.001) explained 94 and 87% of the
variance in systolic and diastolic ABP, respectively. The agreement between
NCBP and ABP was greater than that between CBP and ABP or between HBP ...
When ABP monitoring and HBP monitoring are not options, the NCBP at the
clinic can avoid the white coat bias and therefore improve diagnosis"
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