Blood pressure that rises only in the doctor's office -- so-called "white-coat" hypertension -- may be more serious than widely believed.

Researchers report that patients with white-coat hypertension showed signs of heart damage similar to, but not as severe as, patients with chronic high blood pressure.

Currently, experts remain divided on whether white-coat hypertension, which is thought to be due to the stress of a healthcare visit, is a benign condition or a sign of heart disease that should be treated.

The researchers found that the walls of the left ventricle, one of the heart's upper chambers, appeared thicker in patients with white-coat hypertension, compared with those with normal blood pressure levels. They were also more likely to show left ventricular hypertrophy, an enlargement of the chamber linked to the risk of heart attack and stroke.

As expected, those with chronic high blood pressure showed the highest degree of damage to the left ventricle.

Although the study does not explain the underlying mechanism of the left-ventricle changes seen in patients with white-coat hypertension, the authors note that temporary blood pressure increases, caused by exaggerated response to mild stress may have an effect on cardiac growth, leading to hypertrophy.

The results of this study support the hypothesis that white-coat hypertension should not be simply considered a benign condition.

At present, with our knowledge of the benefits of lowering blood pressure and the realization that this usually does not involve complicated or dangerous regimens, it is good policy to treat white-coat hypertensives.

Blood pressure readings are taken in two numbers. The systolic value (the first number in a blood pressure measurement) describes the pressure in the heart during contraction. The second number, the diastolic value, represents the pressure when the heart is at rest between beats.

Blood pressure readings above 140/90 mm Hg are considered high. In this study, white-coat hypertension was defined as having a systolic pressure over 140 or a diastolic pressure over 90 during doctor visits, but a regular daytime blood pressure of 130/80 or less.

Archives of Internal Medicine 2001:161;2677-2681

Dr. Mercola's Comments:

White-coat hypertension is not a common problem, but it has long been regarded as something that should not be treated. This study provides some compelling evidence of the damage that stress alone can cause to the heart. I have long believed that unresolved stress issues are likely to be more significant contributors to health than even diet and exercise. Fortunately, there does appear to be a relatively simple solution that addresses these stress issues very rapidly and, generally, permanently. I first learned this solution, the Emotional Freedom Technique (EFT), in the summer of 2001 and have rapidly grown to appreciate its profound benefits on health. It can be used for many problems, but it is enormously beneficial for those struggling with stress. EFT is a form of psychological acupressure, based on the same energy meridians used in traditional acupuncture to treat physical and emotional ailments for over 5,000 years, but without the invasiveness of needles. Instead, simple tapping with the fingertips is used to input kinetic energy onto specific meridians on the head and chest while you think about your specific problem--whether it is a traumatic event, stress, an addiction, pain, etc.--and voice positive affirmations. To learn more about this technique, including how to perform it, you can check out my free EFT manual. Related Articles: 75% of High Blood Pressure Untreated in US Blood Pressure Treatment Usually Fails Anger Test May Identify Those at Risk of Heart Attack