Pickering T G, James G D, Boddie C, Harshfield G A, Blank S, Laragh J H
Cardiovascular Center, New York Hospital-Cornell University Medical Center, New York, NY 10021.
JAMA. 1988 Jan 8;259(2):225-8.
Twenty-one percent of 292 patients with untreated borderline hypertension (clinic diastolic blood pressures persistently between 90 and 104 mm Hg) were found to have normal daytime ambulatory pressures (defined from a population of normotensive subjects). These patients were defined as having "white coat" hypertension, and they were more likely to be female and younger, to weigh less, and to be more recently diagnosed than patients whose pressure was elevated both in the clinic and during ambulatory monitoring. Patients with white coat hypertension did not show a generalized increase of blood pressure lability, nor an exaggerated pressor response while at work. The phenomenon is more pronounced when blood pressure is measured by a physician than by a technician. In such patients, the pressor response may be relatively specific to the physician's office and lead to significant misclassification of hypertension.
在292例未经治疗的临界高血压患者（诊所舒张压持续在90至104毫米汞柱之间）中，21%被发现日间动态血压正常（根据正常血压人群定义）。这些患者被定义为患有“白大衣”高血压，与诊所和动态监测时血压均升高的患者相比，他们更可能为女性且更年轻，体重更轻，诊断时间更近。“白大衣”高血压患者并未表现出血压波动普遍增加，工作时也没有过度的升压反应。当由医生而非技术人员测量血压时，这种现象更为明显。在此类患者中，升压反应可能相对特定于医生办公室，从而导致高血压的显著误诊。
