Isolated Clinic Normotension
Saturday, Dec 22 2007
A few investigators have now observed a condition in which normal blood pressures in the clinic are accompanied by elevated measures during daily life, a condition termed isolated clinic normotension. A variety of other names have been associated with this condition, including isolated home hypertension (Bobrie et al., 20001), ‘white coat’ normotension (Prattichizzo and Galetta, 1996), reverse ‘white coat’ hypertension (Wing et al., 2002), or masked hypertension (Pickering et al., 2002). For our purposes, let’s refer to the condition as isolated clinic normotension to be consistent with the terminology used to describe isolated clinic hypertensive patients.
Prior to the advent of reliable ambulatory technologies, physicians were unaware that isolated clinic normotension existed. It was simply assumed that patients who had normal blood pressure values in the clinic also maintained these normal values during daily life. This assumption, however, turned out to be incorrect.
Although the existence of isolated clinic normotension was acknowledged in some earlier work with ambulatory instrumentation (Hoegholm et al., 1992), the prevalence of these individuals was unknown until relatively recently. Results now from several studies have confirmed that isolated clinic normotension is very common, with prevalence estimates ranging from 10 to 45 percent among patients with normal clinic blood pressures (Bobrie et al., 2001; Donner-Banzhoff et al., 1998; Larkin, Schauss, and Elnicki, 1998a; Segre et al., 2003; Selenta, Hogan, and Linden, 2000; Wing et al., 2002).
Although the exact prevalence of isolated clinic normotension in the general population is yet unknown, there is clear evidence that it occurs frequently and that hypertension is presumably undetected in these individuals.
Larkin, K. T., Taylor, B. K., Hernandez, D. H., Goodie, J. L., Doyle, A., O'Quinn, S. R.
Published with assistance from the foundation established in memory of Amasa Stone Mather of the Class of 1907, Yale College.
- Abel, J. A., and Larkin, K. T. (1991). Assessment of cardiovascular reactivity across laboratory and natural settings. Journal of Psychosomatic Research, 35, 365 - 373.
- Achmon, J., Granek, M., Golomb, M., and Hart, J. (1989). Behavioral treatment of essential hypertension: A comparison between cognitive therapy and biofeedback of heart rate. Psychosomatic Medicine, 51, 152 - 164.
- Agras, W. S., Horne, M., and Taylor, C. B. (1982). Expectation and the blood-pressure-lowering effects of relaxation. Psychosomatic Medicine, 44, 389 - 395.
- Agras, W. S., Taylor, C. B., Kraemer, H. C., Southam, M. A., and Schneider, J. A. (1987). Relaxation training for essential hypertension at the worksite: II. The poorly controlled hypertensive. Psychosomatic Medicine, 49, 264 - 273.
- Aivazyan, T. A., Zaitsev, V. P., Khramelashvili, V. V., Golenov, E. V., and Kichkin, V. I. (1988). Psychophysiological interrelations and reactivity characteristics in hypertensives. Health Psychology, 7, 137 - 144.
- al'Absi, M., and Wittmers, L. E. (2003). Enhanced adrenocortical responses to stress in hypertension-prone men and women. Annals of Behavioral Medicine, 25, 52 - 33.
- Albright, C. L., Winkleby, M. A., Ragland, D. R., Fisher, J., and Syme, S. L. (1992). Job strain and prevalence of hypertension in a biracial population of urban bus drivers. American Journal of Public Health, 82, 984 - 989.
- Davidyan, A. (1989). Emotional factors in essential hypertension. Psychosomatic Medicine, 55, 505 - 517.
- Alfredsson, L., Davidyan, A., Fransson, E., de Faire, U., Hallqvist, J., Knutsson, A., et al. (2002). Job strain and major risk factors for coronary heart disease among employed males and females in a Swedish study on work, lipids, and fibrinogen. Scandinavian Journal of Work, Environment and Health, 28, 238 - 248.
Last revised: by Dr. Loren Hooper, M.D.
Provided by Armina Hypertension Association
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