Abstract

The article summarizes current information on blood pressure changes in children during clinic visit. White coat as a general dressing of physicians and health care personnel has been widely accepted at the end of the 19th century. Two problems can be associated with the use of white coat: white coat phenomenon and white coat hypertension. Children often attribute pain and other unpleasant experience to the white coat and refuse afterwards cooperation with examinations. Definition of white coat hypertension in the literature is not uniform. It has been defined as elevated blood pressure in the hospital or clinic with normal blood pressure at home measured during the day by ambulatory blood pressure monitoring system. White coat effect is defined as temporary increase in blood pressure before and during visit in the clinic, regardless what the average daily ambulatory blood pressure values are. Clinical importance of white coat hypertension is mainly because of higher risk for cardiovascular accidents that are dependent on end organ damage (heart, vessels, kidney). Current data do not allow any clear recommendations for the treatment. Pharmacological therapy is usually started in the presence of hypertrophic left ventricle, changes in intimal/medial wall thickness of carotic arteries, microalbuminuria and other cardiovascular risk factors. Nonpharmacological therapy is less controversial and certainly more appropriate. Patients have to change their life style, need to eliminate as much cardiovascular risk factors as possible and sustain a regular blood pressure monitoring.

Highlights

  • White coat as a general dressing of physicians and health care personnel has been widely accepted at the end of the 19th century

  • According to some authors white coat hypertension is present when mean blood pressure value is within the interval of hypertension and ambulatory blood pressure monitoring measured values are within normal limits [3]

  • Clinical importance of white coat hypertension is mainly because of higher risk for cardiovascular accidents that are dependent on end organ damage [31]

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Summary

Introduction

White coat as a general dressing of physicians and health care personnel has been widely accepted at the end of the 19th century. It has been considered as an abnormally elevated blood pressure in hospital or clinic with personnel wearing white coats. According to some authors white coat hypertension is present when mean blood pressure value is within the interval of hypertension and ambulatory blood pressure monitoring measured values are within normal limits [3].

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