So-called white-coat hypertension, where blood-pressure readings are higher in the doctors office than elsewhere, may be responsible for more than a third of cases classified as resistant hypertension. A Spanish study of 8,295 patients in a national hypertension registry found that 37.5% of those diagnosed with resistant hypertension actually had normal blood pressure outside the doctors office. Participants all had readings of at least 140 and/or 90 mm Hg despite being treated with full doses of three or more high-blood-pressure medications. Measured in the doctors office, the subjects averaged readings of 161/88. But when measured using 24-hour ambulatory monitoring, the overall readings averaged 134/75, and only 62.5% still had blood pressure high enough to qualify as resistant hypertension. Researchers concluded, Ambulatory blood-pressure monitoring continues to be needed and must be encouraged for a correct diagnosis and management of all hypertensive patients not controlled on three or more antihypertensive drugs.
TO LEARN MORE: Hypertension, online before print, hyper.ahajournals.org/cgi/content/abstract/HYPERTENSIONAHA.110.168948v1.