Why does blood pressure change when you enter the hospital?

It has long been found that the blood pressure measured in the clinic is different from that outside the clinic. Usually, the blood pressure measured by doctors in the clinic is higher than that measured by patients’ friends at home.

Why is this happening? Is the sphygmomanometer at home not allowed? Why does blood pressure change after entering the hospital? This phenomenon is called “white coat effect”. It is precisely because of the existence of this “white coat effect”, Some doctors suggest that patients’ friends should add 5 mmHg when measuring their blood pressure at home. For example, a patient’s friend measured his blood pressure at home at 135/85 mmHg, Then add 5 mmHg and that’s 140/90 mmHg. In other words, If the blood pressure measured by the patient’s friend at home exceeds 135/85 mmHg, It is time to be alert to whether you suffer from hypertension. Some patients’ friends are diagnosed with mild to moderate hypertension every time they measure their blood pressure in hospitals or clinics. The environment outside the hospital is completely different, Every time the blood pressure was measured, We call this condition [white coat hypertension]. Studies have found that white coat hypertension is not uncommon, The incidence of the disease ranged from 10% to 20%, Particularly among children and the elderly, With the development of diagnosis, prevention and treatment of hypertension, white coat hypertension has attracted more and more attention. For patients suspected of white coat hypertension, we often recommend 24-hour ambulatory blood pressure monitoring. If the following two items are met at the same time, it can be diagnosed as [white coat hypertension]: (1) systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg in the clinic; (2) The ambulatory blood pressure during the day is less than 135 mmHg in systolic blood pressure and less than 80 mmHg in diastolic blood pressure. Is what at work? Many scholars believe that white coat hypertension may be related to the stress reaction and alert reaction of patients, There is some truth in this. Some studies have shown that nurses measure blood pressure lower than doctors, and point out that nurses measure blood pressure to help reduce the occurrence of hypertension in white coats. Is it not that nurses are generally more amiable than doctors? Other scholars believe that, White coat hypertension is a prelude to hypertension, Foreign studies have found that 70% ~ 80% of the friends of patients diagnosed with white coat hypertension will develop real hypertension within 5 ~ 6 years. Other scholars pointed out that White coat hypertension patients have metabolic disorders such as blood lipid and blood sugar, The levels of low density lipoprotein, triglyceride and cholesterol were higher than normal, High density lipoprotein is lower than normal. Therefore, For friends of patients diagnosed with white coat hypertension, We must not take it lightly, Or should we actively improve our lifestyle as much as possible, And closely monitored the blood pressure changes during the follow-up, If blood pressure is found to rise, corresponding treatment should be given in time. Blood pressure not only increases, It may also be reduced. After we know the fox tail of [white coat hypertension], We should also be vigilant: [Cunning] High blood pressure has another way to [lurk] in the human body-[white coat high blood pressure]. As the name implies, Friends of patients with [anti-white coat hypertension] often find elevated blood pressure when they test their blood pressure at home. When they come to the hospital full of distress, hypertension will [pretend to be cute and innocent] in front of the doctor, hiding its fox tail well, making friends of patients more confused: [How is blood pressure normal again? ] In this case, the doctor will also recommend the patient’s friend to do a 24-hour ambulatory blood pressure monitoring. In this way, the [cunning] hypertension thinks that it is out of the doctor’s sight and starts to be arrogant without scruple. Through ambulatory blood pressure monitoring, if the two items are met at the same time, it can be diagnosed as [white coat hypertension]. (1) daytime blood pressure ≥ 135/85 mmHg; (2) 24-hour mean blood pressure ≥ 130/80 mmHg. There was no significant difference among different populations, countries, nationalities, ages and genders, The cause of the disease is still unclear. A large number of literature reports have confirmed that it is related to obesity, drinking, smoking, caffeine and other factors. Some scholars believe that such patients have abnormal [alert reaction], Causing a drop in blood pressure due to emotional relaxation in the clinic. To sum up, On the premise of asking a doctor to troubleshoot the sphygmomanometer at home, This [change] is not a change in the true sense, It is a reaction after seeing a white coat. How to find these two blood pressure changes is a difficult problem for clinicians. Because it is impossible for us to monitor the ambulatory blood pressure of all patients with normal blood pressure who come to the hospital one by one. Therefore, improving the public’s awareness of hypertension prevention and treatment, regular physical examination, and popularizing family self-test blood pressure are the key points to expose the fox’s tail to the white coat hypertension in the early stage.