Lantelme P, Milon H
Service de cardiologie, hôpital de la Croix-Rousse, EA 645, 103, Grande-rue de la Croix-Rousse, 69004 Lyon.
Arch Mal Coeur Vaiss. 2000 Dec;93(12):1534-40.
White coat hypertension and the white coat effect are common clinical problems. Although they have similar names, they do not correspond to strictly identical entities. The white coat effect is an increase in blood pressure induced by the physician. It may be observed for all degrees of mean blood pressure and it is usually assessed by the difference between conventional and ambulatory blood pressure values. White coat hypertension is a qualitative status associating clinical hypertension and "normotension" outside the physician's office. In practice, the application of these definitions presents many difficulties. The usual methods of evaluating the white coat effect are a poor marker of the true effect as measured by continuous blood pressure monitoring. White coat hypertension has many definitions, both with respect to the threshold of clinical hypertension and to that of ambulatory normotension. Any attempt at evaluating the prognosis of these two conditions are faced with these considerations. However, the cardiovascular consequences which result appear to be mild and, usually, do not justify drug therapy. Their principal implications are above all diagnostic as they may lead to the erroneous assumption of severe or drug-resistant hypertension.
白大衣高血压和白大衣效应是常见的临床问题。尽管它们名称相似，但并非严格相同的实体。白大衣效应是由医生导致的血压升高。在所有平均血压水平均可观察到，通常通过常规血压值与动态血压值之间的差异来评估。白大衣高血压是一种定性状态，指在诊室之外存在临床高血压与“血压正常”的情况。在实际应用中，这些定义的使用存在诸多困难。评估白大衣效应的常用方法，对于通过连续血压监测所测量的真实效应而言，是一个较差的指标。白大衣高血压有许多定义，涉及临床高血压的阈值以及动态血压正常的阈值。任何评估这两种情况预后的尝试都需考虑这些因素。然而，由此产生的心血管后果似乎较为轻微，通常并不需要药物治疗。它们的主要影响首先在于诊断方面，因为它们可能导致错误地认定为重度高血压或难治性高血压。
