Some hypertensive or non-hypertensive patients have an impressive pressure response to medical environment (white coat phenomenon) but its presence, amplitude and duration is unlikely to be predicted routinely. Despite the common observations that “anxious” patients may have, in the medical environment, marked blood pressure (BP) increase, no psychological variable had been linked before, in formal analyses to white coat phenomenon. To investigate the possible relationships between patient's psychological profile and white coat phenomenon 70 patients undergoing ambulatory blood pressure (ABP) monitoring have been studied. Thirty-five patient who presented white coat phenomenon (defined as office BP > 20% of mean 24-hour ABP values) and 35 comparable patients who did not present with this reaction underwent the following psychometric tests: Cognitive Behavioral Assessment H (CBAH), Multidimensional Anger Inventory (MAI), State-Trait Anger Inventory (STAXI), Hostility Inventory (HO), Satisfaction Profile (SAT-P), and Coping Orientation to Problems Experienced (COPE). Particularly, the analysis of the COPE showed a significant difference between patients with and without white coat phenomenon in 3 scales: planning, suppression of competitive activities, and mental disengagement. White coat phenomenon appears to be linked (p < 0.025, Fisher's exact probability test) to psychological constructs characterized by high coping and planning ability but also by a high avoiding strategy. Theses data indicate that patients who do not define themselves as “anxious”, reveal high coping and planning capabilities addressed toward the cognitive resolution of a stressing situation (such as BP measurement), but do not accompany these strategies with an adequate behavioral response, are likely to show an overt BP increase in the medical environment.