A case of an extreme white coat effect. (2nd January 2020)

• Record Type: Journal Article
• Authors: Nyvad, Jakob; Reinhard, Mark; Christensen, Kent L.
• Is Part Of: Blood pressure. Volume 29:Number 1(2020)
• Page Start: 63
• Page End: 67
• Publication Date: 2020-01-02
• Subjects: White-coat hypertension -- blood pressure -- arterial pressure -- hypertension -- anxiety -- stroke -- cardiovascular diseases; Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.1080/08037051.2019.1658517
• Languages: English
• ISSNs: 0803-7051

Abstract

Abstract: In this report, we present a challenging case of a 63-year-old Caucasian woman with an extreme stress response to blood pressure (BP) measurements. Office- and ambulatory BP measurements consistently found systolic BP above 200 mmHg. However, antihypertensive medication made her dizzy and extremely unwell, and she could barely tolerate treatment with a moderate dose of angiotensin-converting enzyme (ACE) inhibitor. Finger-cuff-based measurements (Finapres Finometer®) revealed extreme hypertension in relation to contact with medical professionals, but hypotension when the patient was seated alone unobserved. Months after, the patient suffered a hemorrhagic stroke possibly related to her extreme BP-fluctuations in stressful situations.