The role of behavioral factors in white coat and sustained hypertension

T. G. Pickering, R. B. Devereux, W. Gerin, G. D. James, C. Pieper, Y. R. Schlussel, P. L. Schnall

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Studies using ambulatory monitoring of blood pressure have indicated that patients with persistently elevated clinic pressure may be subdivided into two groups, those in whom ambulatory pressures is also elevated (persistent hypertension), and those in whom it is normal (white coat hypertension). The role of behavioral factors in contributing to these two types is discussed. Studies of white coat hypertension suggest that it is not characterized by any generalized physiological abnormality, and that target-organ damage is mild and the prognosis relatively benign. It may present a conditioned response to the physician. Behavioral factors can significantly influence the diurnal profile of blood pressure, as shown by a comparison of ambulatory pressures recorded on working and non-working days, and in women who experience varying levels of occupational and domestic stress. The role of behavioral factors in the development of sustained hypertension (defined as an upward resetting of the diurnal profile), however, is much less clear. A cross-sectional study of normotensive and hypertensive men has shown that men employed in high-strain jobs are more likely to show a sustained elevation of blood pressure.

Original languageEnglish (US)
Pages (from-to)S141-S147
JournalJournal of hypertension
Issue numberSUPPL. 7
StatePublished - 1990

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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