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White Coat Effect Linked With Increased Blood Pressure Response To Physical Activity
A DGReview of :"The white-coat effect is associated with increased blood pressure reactivity to physical activity"
Blood Pressure Monitoring
09/18/2002
By Andrew A. Skolnick
Patients who have a significant 'white coat' blood pressure effect may experience greater blood pressure load during regular daily activities, which could contribute to target-organ damage.
Dr. Andrew C. Leary at Cork University Hospital in Cork, Ireland, and colleagues investigated whether blood pressure reactivity to the stress of a clinic visit - the so-called white coat effect - is associated with increased blood pressure response to physical activity.
The researchers prospectively studied 421 patients referred to their clinic for assessment of hypertension. Each patient underwent 24-hour ambulatory blood pressure monitoring and simultaneous actigraphy.
The difference between mean clinic blood pressure and mean daytime ambulatory blood pressure was considered a measure of the white-coat effect, the investigators noted. The presence or absence of a white-coat effect was added to a mixed model regression of blood pressure on mean activity score for the 10-minute interval preceding blood pressure measurement.
The researchers noted a white coat effect on systolic blood pressure in 259 patients and on diastolic blood pressure in 264 patients. Coefficients for the regressions of both systolic and diastolic blood pressure on physical activity levels were significantly higher in those who had a white-coat effect, they reported.
"These data suggest increased blood pressure reactivity to activity in those with a white-coat effect," the researchers concluded. "Patients with a prominent white-coat effect may experience greater blood pressure load during normal daily activities as a consequence of increased blood pressure reactivity. In patients with white-coat hypertension, this may contribute to target-organ damage."
Blood Press Monit 2002; 7: 209-213.
"The white-coat effect is associated with increased blood pressure reactivity to physical activity"
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