Hussain Mahmud, Naveed Akhtar, Muhammad Toqeer Alam, Hina Waseem.
White coat effect in Pakistan: A comparison between blood pressures measured in physician`s office and ambulatory monitoring.
Pak J Cardiol Jan ;16(3):127-30.

Background: White coat effect is the difference between the clinic blood pressure (BP) and ambulatory blood pressure monitoring (ABPM), regardless of the normality or otherwise of either BP; due to an abnormally vigorous sympathetic response in the presence of a health professional measuring the blood pressure. Despite a high prevalence of hypertension in effect in our country. We undertook this study to document the existence of white coat effect in our population by comparing blood pressure reading taken in physician`s office with 24 hour average A ^. Methods: The study population consisted of 50 hypertensive patients presenting to KRL Hospital in Islamabad, Pakistan. All the subjects underwent 24 hour ABPM. The first reading taken by the doctor and average ambulatory blood pressure were comparedusing the paired t test. Results: There was a difference of about 10 mm Hg between the means of the paired readings i.e. the two systolic and diastolic pressures. The difference between the paired values of first reading and average BP blood pressures was statistically significant with p values <0.000. Discussion: The significant difference between the two blood pressures shows that white coat effect exists in our population. The blood pressure measurements done in the physician`s office may not be sufficiently accurate and lead the patient to be labeled as uncontrolled. ABM is a more accurate way of determining the management and prognosis of hypertensive patients.

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