‘White coat’ impact on blood pressure confuses heart disease diagnostics

According to a landmark study published in the British Medical Journal (BMJ) some patients with high blood pressure will see their pressure levels climb even higher, if a doctor is taking the measurements. In a way, this is a direct example of how anxiety or stress impacts on the cardiovascular system.

High blood pressure affects about 40% of adults in the UK and is a major risk factor for heart attack, heart failure, kidney disease and stroke. It was already known that some patients getting their blood pressure levels checked by a doctor can suffer what’s known as the ‘white coat’ effect – their blood pressure levels increase due to nerves or stress at being in a clinical setting.

The study involving 8,575 patients has shown that the ‘white coat’ effect is more dramatic in patients with very high blood pressure - their blood pressure levels can rise by as much as 29 units if a doctor checks it, compared with a rise of 17 units if a nurse is taking the measurement.

The point is that finding an accurate indicator of cardiovascular or heart disease has traditionally been difficult. The best diagnostic tests remain in the hands of the experts and require sophisticated instrumentation such as Dual-Source Infinity CT and Cardiac Specialists such as Professor Avijit Lahiri.