One of the biggest health problems in the United States today is high blood
pressure. It is reaching epidemic proportions. Often a silent killer, high blood
pressure may show no symptoms until levels are very elevated. I see high blood
pressure and its consequences every day in my patients.
In our cardiology practice, approximately one-half to two-thirds of people who come in for evaluation of heart rhythm disorders already have high blood pressure. It is one of the most common causes of atrial fibrillation, heart failure, and stroke.
White Coat Hypertension: When Stress Spikes Blood Pressure
What is white coat hypertension? It is a condition in which your blood pressure is higher in a physician’s office, but is otherwise normal.
What makes your blood pressure go up in a doctor’s office? Most people say they are anxious or worried they may receive bad news. Or it may be the cost of their appointment or of medical care. Anxiety and stress are important causes of blood pressure elevation.
To take your blood pressure, ideally you should be seated and relaxed. And typically, once seated, you should wait three to five minutes before measuring your blood pressure. Then, the best practice is to take three measurements in each arm and average the readings.
Most of you are probably thinking that this never happens when you see a doctor, because most offices are busy and check people in quickly without taking the time to correctly measure your blood pressure. But if you go to a high blood pressure clinic, this process will sound familiar.
Another important aspect to consider is that not all blood pressure machines and devices are the same. Blood pressure devices are only as good as the readings they provide. Most adults need a full-size or adult-size, large blood pressure cuff that goes around the upper arm. Smaller devices that are placed on the wrist or ankle tend to be less accurate.
If you have a blood pressure machine you use at home, bring it in to your doctor’s office and compare readings. Oftentimes, we will find the measurements are similar. However, at times we find that the home machine reading is either too high or low. Most of the time, we find that the blood pressure cuff is too small.
Assuming your blood pressure is measured correctly, and in the office it is still higher than at home, does white coat hypertension matter? The general sense of my patients is no, because the blood pressure values are not the same as those measured at home. I agree with this partially, as errors can occur in a doctor’s office. But what is important to consider is that the doctor’s office blood pressure measurements can give you some insight into how your body deals with situational stress.
We all face many stresses each day, many of which we cannot avoid. These may come from our jobs, commutes, spouse or family relationships, financial issues, health problems, and more. If each time we face stress our blood pressure skyrockets to very high levels, our hearts can be strained and injured. In this regard, white coat hypertension that reflects our response to stress can be a marker of heart disease risk.
White Coat Hypertension, Stress, and Heart Disease Risk
A new white coat hypertension study, published in Hypertension in June 2015, looked at heart disease risk. The study included 3,200 people in Italy. These patients were seen in a doctor’s office for three blood pressure measurements. Then they were sent home with a 24-hour blood pressure monitor that sampled their blood pressure every 20 minutes. When the patients returned, they had three more office blood pressure measurements. With these measurements, the researchers could determine what was happening to the blood pressure in the doctor’s office and throughout the day.
White coat hypertension was diagnosed if the average office blood pressure measurement was higher than 140 mgHg for systolic blood pressure or higher than 90 mmHg for diastolic blood pressure but the 24-hour average blood pressures (at home) were normal.
Then the investigators divided the group with white coat hypertension into two: those who experienced high blood pressure frequently with stress, and those who experienced high blood pressure occasionally with stress.
This is a summary of their findings about heart disease risk over 20 years of follow-up care:
Heart disease mortality was strongly associated with white coat hypertension.
The risk was higher for those whose white coat hypertension was stable (all blood pressure levels were high when at the doctor’s) compared to those whose pressure was unstable (one of two blood pressure levels at the doctor’s were high). Specifically, when compared to people without white coat hypertension, risk of heart-disease related death increased 2.4 times in those with unstable white coat hypertension and 16 times in those with stable white coat hypertension.
Total mortality was 1.9 times higher in people with stable white coat hypertension compared to those without white coat hypertension.
These risks increased as people aged, in men compared with women, and in people with a larger body mass indexes (BMI).
E-mail us on pkdclinic888@hotmail.com or kidneyservice@hotmail.com to get more information.
Or you can just consult our online doctor for timely help. They are online for 24hours every day.
Or you can add Whatsapp:+8618330162295 is also available for you.
It’s free of charge.
In our cardiology practice, approximately one-half to two-thirds of people who come in for evaluation of heart rhythm disorders already have high blood pressure. It is one of the most common causes of atrial fibrillation, heart failure, and stroke.
White Coat Hypertension: When Stress Spikes Blood Pressure
What is white coat hypertension? It is a condition in which your blood pressure is higher in a physician’s office, but is otherwise normal.
What makes your blood pressure go up in a doctor’s office? Most people say they are anxious or worried they may receive bad news. Or it may be the cost of their appointment or of medical care. Anxiety and stress are important causes of blood pressure elevation.
To take your blood pressure, ideally you should be seated and relaxed. And typically, once seated, you should wait three to five minutes before measuring your blood pressure. Then, the best practice is to take three measurements in each arm and average the readings.
Most of you are probably thinking that this never happens when you see a doctor, because most offices are busy and check people in quickly without taking the time to correctly measure your blood pressure. But if you go to a high blood pressure clinic, this process will sound familiar.
Another important aspect to consider is that not all blood pressure machines and devices are the same. Blood pressure devices are only as good as the readings they provide. Most adults need a full-size or adult-size, large blood pressure cuff that goes around the upper arm. Smaller devices that are placed on the wrist or ankle tend to be less accurate.
If you have a blood pressure machine you use at home, bring it in to your doctor’s office and compare readings. Oftentimes, we will find the measurements are similar. However, at times we find that the home machine reading is either too high or low. Most of the time, we find that the blood pressure cuff is too small.
Assuming your blood pressure is measured correctly, and in the office it is still higher than at home, does white coat hypertension matter? The general sense of my patients is no, because the blood pressure values are not the same as those measured at home. I agree with this partially, as errors can occur in a doctor’s office. But what is important to consider is that the doctor’s office blood pressure measurements can give you some insight into how your body deals with situational stress.
We all face many stresses each day, many of which we cannot avoid. These may come from our jobs, commutes, spouse or family relationships, financial issues, health problems, and more. If each time we face stress our blood pressure skyrockets to very high levels, our hearts can be strained and injured. In this regard, white coat hypertension that reflects our response to stress can be a marker of heart disease risk.
White Coat Hypertension, Stress, and Heart Disease Risk
A new white coat hypertension study, published in Hypertension in June 2015, looked at heart disease risk. The study included 3,200 people in Italy. These patients were seen in a doctor’s office for three blood pressure measurements. Then they were sent home with a 24-hour blood pressure monitor that sampled their blood pressure every 20 minutes. When the patients returned, they had three more office blood pressure measurements. With these measurements, the researchers could determine what was happening to the blood pressure in the doctor’s office and throughout the day.
White coat hypertension was diagnosed if the average office blood pressure measurement was higher than 140 mgHg for systolic blood pressure or higher than 90 mmHg for diastolic blood pressure but the 24-hour average blood pressures (at home) were normal.
Then the investigators divided the group with white coat hypertension into two: those who experienced high blood pressure frequently with stress, and those who experienced high blood pressure occasionally with stress.
This is a summary of their findings about heart disease risk over 20 years of follow-up care:
Heart disease mortality was strongly associated with white coat hypertension.
The risk was higher for those whose white coat hypertension was stable (all blood pressure levels were high when at the doctor’s) compared to those whose pressure was unstable (one of two blood pressure levels at the doctor’s were high). Specifically, when compared to people without white coat hypertension, risk of heart-disease related death increased 2.4 times in those with unstable white coat hypertension and 16 times in those with stable white coat hypertension.
Total mortality was 1.9 times higher in people with stable white coat hypertension compared to those without white coat hypertension.
These risks increased as people aged, in men compared with women, and in people with a larger body mass indexes (BMI).
E-mail us on pkdclinic888@hotmail.com or kidneyservice@hotmail.com to get more information.
Or you can just consult our online doctor for timely help. They are online for 24hours every day.
Or you can add Whatsapp:+8618330162295 is also available for you.
没有评论:
发表评论