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Heart Health

Could white-coat hypertension harm your heart?

November 29, 2019

About the Author

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Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio
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Kimberly B Tuomi
December 9, 2019

Notice the picture of the woman getting her blood pressure taken…her back is not supported and her arm is down. Looks like she is on an exam.table which means her legs are dangling.
The problem is people are quickly seated on an exam table, talking or answering questions, feet need to ge on the ground and back supported and don’t take it till at least 3 min are past after seating. Take it twice if necessary and use the right size cuff!

Judith Klingels
December 9, 2019

Totally in agreement with you Vik.

mohammad momen
December 9, 2019

nice and new, thanks.

Linda McKee
December 9, 2019

I want to thank Vin Khanna for clarifying the difference between relative and absolute risk. Too often doctors use only relative risk statistics which scare patients into compliance, while the poor patient has no idea of what their real risk is. I also appreciate the pointing out that “blood pressure thresholds rise with age. There is no evidence of improvement in morbidity or mortality, for example, in adults over age 60 of treating a blood pressure that is below 150/90 (JNC 8).” The parameters of acceptable blood pressure, along with cholesterol and others have lowered to the point of absurdity. This lowering of acceptable parameters has been very lucrative for pharmaceutical companies.

David Beauregard
December 9, 2019

I have experienced “white coat hypertension” for many years. I experienced a heart attack on April 4th, 2018. The Cardiologist inserted four stents in arteries around my heart. I have consistently taken medications to control hypertension. I exercise 3-4 times weekly, have reduced my salt and my weight has been the same 173 for the last several years. What, if anything, have I missed that I should have been doing to control my Hypertension? Thank you. David Beauregard

Margie Lee
December 9, 2019

Some of these people may have had traumatic medical treatment in the past or are worried about a current medical condition. They may not have elevated blood pressure under other circumstances, like on the road.

Peter Sinclair PhD
December 9, 2019

But is it really the white coat or seeing the doctor. Or, the drive to the doctor’s office and the inevitable wait wait to be seen?

Brian Nambale
December 9, 2019

Thanks this is incredible

James Williams
December 5, 2019


Vik Khanna
November 29, 2019

A very poorly written article.

Her claim that risk of heart disease rises 36% is a meaningless exclamation of relative risk. Unless absolute risk is also stated, the relative risk is completely without context. Since the author is does not understand this or willfully ignored it, I’ll explain: if a person’s absolute risk of a heart attack is 5%, and risk rises by the amount noted, the new level of absolute risk is 6.8%. Not exactly earth shattering.

Further, blood pressure thresholds rise with age. There is no evidence of improvement in morbidity or mortality, for example, in adults over age 60 of treating a blood pressure that is below 150/90 (JNC 8).

Like many things that the medical industry produces, this is meant to frighten people into thinking that they are diseased or in need of treatment.

December 9, 2019

You are correct but this depends on the audience. She could have went on to explain what a heart attack is or what the heart itself is. For people who study medicine or health sciences this should be a clear giveaway (that she is talking about relative risk). She does indeed not mention what the absolute risk is but that is very general and can be found in multiple websites. This is not what the article is focusing on in my opinion

John Julian
December 9, 2019

Vik makes a very good point. We often hear these large percentages of increase risk, but if the initial risk is 1% and a stated increase is 50% the actual risk is elevated to only 1.5%. At 100% it’s 2%. What often a person is led to believe is that his or hers risk is 50% or maybe even 100% which means a sure fact that they are going to succumb to that particular ailment if they don’t take action! I’m not advocating people ignore they’re health and not make a strong effort to lead a healthy life-style and take medications if needed, but the medical field needs to present findings in a honest manner that we can understand.

December 9, 2019

Vik Khanna thank you for that reply!

December 9, 2019

Thank you Vik that was a very helpful and clearly demonstrated response. I had not made the connection between absolute and relative risk in this context. Thank you for saving me time in reading further.!

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