White Coat Phenomenon and White Coat Hypertension Two Phrases with Many Differences A Prospective Controlled Study
Enas Yusuf Abudhena, Nasruddin Emhemed EL-Reyani
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Background and objective: Transient elevation of blood pressure (BP) caused by excitement or apprehension does not necessarily indicate hypertensive disease. Patients with borderline or variable office blood pressure "White Coat" hypertension WCHT are much worried concerning their BP elevation. Therefore, early assessment of this phenomenon would be of prognostic value. Subjects and methods: Two hundred subjects with an average age of 53 years were recruited in the study. Females have showed a large proportion of participant compared to males. A special pro forma sheet designed to meet the requirements of the study was used. The interpretation of data was continued for a period of four months. Results: Overall participants, 56% showed a significant increase in the either systolic or diastolic BP at the clinic visit compared to control group, p<0.05. The sustained normotension (NT) group represents the least increase in BP measurement at clinic visit and home compared with the WCHT group. However, the vast majority of participants have showed a significant decrease in their BP check-ups at homes or away from clinics (75%, p<0.05). Conclusion: Despite that WCHT may not be an entirely innocent phenomenon; the detection of WCHT at clinic side did not consider the need for long-term surveillance to shift patients from WC phenomenon to established WCHT. An argument sometimes raised against the concept of WCHT is that if patients are seen a sufficient number of times in the clinic, blood pressure will return to normal. Again, this may be true in only a minority of patients, but there are many in whom clinic pressure will remain high indefinitely.
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