What is the meaning of white coat uncontrolled hypertension?

summary

White coat hypertension (WCH) refers to that some patients' blood pressure rises when they measure their blood pressure in the doctor's consulting room, but their blood pressure is normal when they measure their blood pressure at home or 24-hour ambulatory blood pressure monitoring (the patient carries the pressure measuring device, and there is no medical staff present). What is the meaning of white coat uncontrolled hypertension? Let's talk about it

What is the meaning of white coat uncontrolled hypertension?

White coat hypertension, also known as "simple clinic hypertension.". These people just measure high blood pressure in the hospital consulting room, change the environment, home self-test blood pressure (day, night) or ambulatory blood pressure monitoring is normal. According to statistics, the incidence of this kind of white coat hypertension accounts for 10% - 15% of the total population, which is really not a small number. However, it should be noted that after the high blood pressure is found in the consulting room, the blood pressure must be measured many times at different times (home self-test), or do ambulatory blood pressure monitoring, in order to determine whether it is really white coat hypertension.

Some people have high blood pressure in the consulting room and normal self-test blood pressure, but when they do ambulatory blood pressure monitoring, they will be exposed. In some periods, especially at night, blood pressure rises significantly. This kind of white coat hypertension is actually fake, the real one is hypertension. Because the self-test blood pressure is usually in the daytime, in the awake state, and it is unlikely to be measured too frequently, so sometimes it can not be found. Ambulatory blood pressure monitoring can tell the truth.

Cerebral cortex excitation and inhibition dysfunction, sympathetic and parasympathetic nerve dysfunction, these people not only see the doctor in the hospital, high blood pressure, encounter things, mental tension, emotional excitement, blood pressure will rise. Studies have found that in patients with white coat hypertension, 3 / 4 have type A behavior, more than 90% have anxiety disorders. Some people observed a group of white coat hypertension for 10 years and found that 42.6% of them, that is, nearly half of them gradually developed into persistent hypertension. And these people have glucose metabolism disorders, new onset diabetes is also increasing.

matters needing attention

Lifestyle interventions, such as reasonable diet (salt restriction, low-fat), moderate exercise, smoking cessation and alcohol restriction to reduce weight, lipid, improve glucose and lipid metabolism disorders, relieve mental stress, improve sleep, and even necessary psychotherapy, are helpful to improve white coat hypertension. If there are many risk factors, target organ damage and high load of blood pressure monitoring, it is not only white coat hypertension, but also drug treatment.