The white coats are coming

Reports on the white coat hypertension in which a person's blood pressure is normal most of the time but suddenly rises when they see a physician. Reverse condition suffered by other patients in which their blood pressure drops in a medical setting resulting in the masking of a possible cardiovascular condition.

By Peter Doskoch, published on September 01, 1996

HIGH BLOOD PRESSURE

HIGH BLOOD PRESSURE has been labeled the "silent killer" because so many of us are unaware we have it. But now it appears that hypertension isn't just quiet--it's devious.

It's long been known that some people suffer "white coat hypertension": their blood pressure is normal most of the time, but suddenly rises when they see a physician. Recently psychologist Kevin Larkin, Ph.D., found that some folks have the reverse condition: their blood pressure drops in a medical setting, masking a possible cardiovascular condition. Larkin, an associate professor at West Virginia University, calls this "white coat normotension."

Larkin and his team followed 64 volunteers over the course of a day, taking their blood pressure every 30 minutes. To his surprise, 11 of the 32 people with normal blood pressure at the clinic showed markedly elevated readings once they left the medical setting. Their blood pressure rose, on average, from a healthy 128 over 80 at the doctor's office to 147 over 96 in the real world well into the range cardiologists consider borderline hypertensive.

Larkin suspects that normotensives deceptively low blood pressure at the doctor's may be a by-product of their fast-paced lives. So stressed are they, he suggests, that office visits may actually seem like a vacation. "It's the only time they're relaxed," he says.

Preliminary psychological data indicate that white coat normotensives aren't much different from the rest of us, although they do smoke and drink more--and, so far, nearly all of them are men. What matters most, however, is that they may also be at risk for heart disease, stroke, and other hazards of hypertension--despite deceptively clean bills of health.

PHOTO (COLOR): Club "med": a visit to the doctor can feel like a vacation.