Aim: To assess the effect of participation in cardiac rehabilitation (CR) program on white coat hypertension (WCH).
Background: WCH is diagnosed when patient exhibit elevated blood pressure in a clinical setting but not in other settings. It is believed that this is due to the anxiety some people experience during a clinic visit. Various studies have shown that the risk of patients with WCH is somewhat elevated but distinctly lower than in patients with sustained hypertension. Some physicians prefer the “wait and see" in WCH, others, take an overtreatment approach, which might result in hypotension and orthostatic symptoms.
Methods: 494 patients who joined Cardiac Rehabilitation (CR)) program in BZ hospital, Haifa, during the period 1.1.2011 -1.1.2013 were assessed retrospectively. Frequency of WCH , demographic indices, risk factors, program adherence time, and blood pressure measurements were evaluated and compared to "true" hypertension (HTN) and all other patients.
Resultes: 33(6.7%) patients of whom 23(69.7%) women and 10(30.3%) men had WCH according to the medical referral letter or by self report compared to 233 (47.2%) with "true" HTN. Adherence time to the CR program of WCH group was 18 weeks +/- 1.5 sd compared to 13.5 +/- 3.6 sd in the whole group, p0.05. Admission systolic BP was 149 mmHg +/- 22 sd compared to 147 +/- 18 in the HTN group, p =ns. Systolic BP in those who completed 3 months of training in WCH group was 124 mmHg +/- 9sd compared to 144 +/- 15 sd in HTN group, p 0.01. Rest heart rate was reduced as well in WCH patients (87 bpm +/- 4.5 sd) after 3 months (77 +/- 4sd), p0.05.
Conclusions: Exercise training in CR settings is beneficial for patients with WCH. The reduction of BP is probably related to the frequent exposure to medical surroundings enabling acquaintance, familiarity feeling, and relaxing effect.
