CIN - ** UNIQUE ASSESSMENT APP by Dr. Neeraj Bhalla **



OPD, BLK Super Speciality


Monday - 11:00 am to 2:00 pm

Thursday - 11:00 am to 2:00 pm

Friday - 2:00 pm to 5:00 pm

Room No. 115

OPD 3, 1st Floor

For Appointments Call

8860017412 / 8130698143 / 011 30403040

White Coat Hypertension

What's White Coat Hypertension ( and why it could be important for you to know) ?

When you go to visit a doctor , how do you feel? Relaxed as if you were going to see a movie? Looking forward to it as a trip to your favourite restaurant? No, more likely you feel nervous, anxious and tense. Is it any wonder then that your blood pressure is higher than normal? Doctors are beginning to realize that in many instances the blood pressures recorded in their clinic of their patients are not a true reflection , but are artificially high. The term for this condition is White Coat Hypertension, and it affects upto 25-30% of people who visit a doctor. It affects both first time visitors as well as known patients of high blood pressure.

Imagine the consequence of a diagnosis of High blood pressure to a perfectly normal person? A lifetime of medication, the psychological burden of being labeled as having a disease.. and all because of a mistaken diagnosis? Well doctors now realize that being in a hospital or clinic environment may not the best place to record blood pressures and various techniques and measures have been advocated to unmask this problem and obtain a more true picture of the actual situation.

First it may not be the best idea for a doctor to record the blood pressure, rather a less threatening figure might be a nurse or even an automated record with an electronic device. Make the patient relax by sitting quietly and reading a book or magazine while the BP is being recorded. These are a few techniques to minimize the White Coat effect in a hospital or clinic setting. Recording the blood pressure in the patients home environment reflects a more accurate picture and should be used to guide diagnosis as well as treatment.

There are now available devices that record the blood pressure over the entire 24 hours and these are called Ambulatory Blood Pressure Recorders. Basically the device consists of a recorder connected to a BP cuff which automatically inflates at random times once or twice an hour. The readings are interpreted in a graphic and tabular form. Certain normal patterns have been identified : basically the blood pressure is seen to dip at night and rise early in the morning. The average daytime , night time pressures as well as the 24 hour average are assessed and High blood pressure is diagnosed if daytime average exceeds135/85 mmHg and/or the 24h average exceeds 130/80 mmHg. It is now understood that this type of recording not only helps in diagnosis but also gives important prognostic insights and also helps in guiding treatment. Once you have a picture of the patients blood pressure throughout the day it is better possible to adjust the patients medication rationally rather than based on a single reading in the clinic.