What is white coat hypertension?

• A. Elevated blood pressure readings in the clinical setting due to anxiety, with normal readings outside clinic
• B. Hypertension caused by wearing white coats
• C. Elevated readings only at home
• D. A temporary drop in BP during office visit

Answer: (A)

White coat hypertension occurs when a patient’s blood pressure rises in a clinical setting due to anxiety or stress, while readings taken outside the clinic are normal. The clinical environment and anticipation of being measured can trigger a brief activation of the sympathetic nervous system, causing a spike in BP during the visit. This distinction matters because it prevents mislabeling someone as chronically hypertensive based only on office measurements; to confirm true hypertension, clinicians may use home or ambulatory blood pressure monitoring to see if elevated pressures persist outside the office. The other ideas don’t fit: it isn’t caused by wearing a white coat; it isn’t elevated only at home; and it isn’t a temporary drop in BP during an office visit.