Blood pressure monitoring
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Blood pressure monitoring · Oct 1996
Office hypertension: abnormal blood pressure regulation and increased sympathetic activity compared with normotension.
The percentage of patients with office or white-coat hypertension has been reported in international studies to be 20-30% of the hypertensive population. These patients can be identified and distinguished from patients with established hypertension by ambulatory blood pressure monitoring (ABPM) or self-measurement. There is still no satisfactory explanation for the phenomenon of 'office hypertension' and there are no data available to show how the blood pressure behaviour of office hypertensives differs from that of normotensive subjects away from the physician's office or clinic environment. ⋯ Patients with office hypertension, who by definition do not yet have established hypertension, already exhibit abnormal regulation both of systolic and of diastolic blood pressure during the morning period and daytime, with a significantly greater early morning rise compared with normotensive subjects and a greater blood pressure amplitude (amplitude hypertension) due to lower blood pressure during night-time and higher blood pressure during the day with increased sympathetic activation. Office hypertension seems to be the earliest manifestation of hypertension.