White coat syndrome and its variations: differences and clinical impact

Abstract

Mariana R Pioli,1 Alessandra MV Ritter,1 Ana Paula de Faria,1 Rodrigo Modolo1,2 1Department of Pharmacology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil; 2Laboratory of Cardiac Catheterization, Department of Internal Medicine, Cardiology Division, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil Abstract: Hypertension is closely linked to increased cardiovascular risk and development of target organ damage (TOD). Therefore, proper clinical follow-up and treatment of hypertensive subjects are mandatory. A great number of individuals present a variation on blood pressure (BP) levels when they are assessed either in the office or in the out-of-office settings. This phenomenon is defined as white coat syndrome – a change in BP levels due to the presence of a physician or other health professional. In this context, the term “white coat syndrome” may refer to three important and different clinical conditions: 1) white coat hypertension, 2) white coat effect, and 3) masked hypertension. The development of TOD and the increased cardiovascular risk play different roles in these specific subgroups of white coat syndrome. Correct diagnose and clinical guidance are essential to improve the prognosis of these patients. The aim of this review was to elucidate contemporary aspects of these types of white coat syndrome on general and hypertensive population. Keywords: hypertension, white coat effect, white coat hypertension, masked hypertension, cardiovascular risk

Keywords

• Hypertension
• white coat effect
• white coat hypertension
• masked hypertension
• cardiovascular risk