The Effects of Talking, Reading, and Silence on the “White Coat” Phenomenon in Hypertensive Patients

• Published in: American journal of hypertension Vol. 11; no. 2; pp. 203 - 207
• Main Authors: Le Pailleur, Claude, Helft, Gérard, Landais, Paul, Montgermont, Patrick, Feder, Jean M, Metzger, Jean P, Vacheron, André
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1998; Oxford University Press; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Female; Humans; Hypertension; Hypertension - physiopathology; Male; Medical sciences; Middle Aged; pathophysiology; Prospective Studies; Reading; reading effect; talking effect; white coat effect; Hypertension; talking effect; white coat effect; reading effect; pathophysiology; Human; Measurement; Reading; Silence; Physician patient relation; Cardiovascular disease; Exploration; Speech; Blood pressure
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(97)00403-2

To explore the mechanisms of the “white coat” phenomenon, the effects of talking, reading, and silence were analyzed. Fifty essential hypertensive patients were randomly allocated to periods of stress talking and relaxing reading, alternating with three periods of silence. While talking, systolic/diastolic blood pressure increased sharply, from 142 ± 0.7/97.7 ± 0.5 mm Hg to 159 ± 0.7/111 ± 0.5 mm Hg ( P < .0001). While reading, systolic/diastolic blood pressure decreased ( P < .0001). Moreover, talking and reading had opposite residual effects. The silence and reading periods gave the best approximations of the daytime ambulatory period. The predictive value of clinical blood pressure can be improved if measured during a period without talking, thus decreasing the “white coat” phenomenon.