MENTAL ARITHMETIC IS A USEFUL DIAGNOSTIC EVALUATION IN WHITE COAT HYPERTENSION

It remains unclear whether patients with white coat hypertension are m ore susceptible to mental stress than are those with essential hyperte nsion. To compare the presser responses to mental arithmetic between t he two types of hypertension, 21 untreated female outpatients, aged 42 to 64 (mean 55) years, with hypertension, were studied. After 2 weeks of self-monitoring blood pressure, 11 patients were diagnosed as havi ng white coat hypertension and the remaining 10 patients were diagnose d as having essential hypertension. The systolic and diastolic blood p ressure responses to mental arithmetic testing were significantly grea ter in the patients with white coat hypertension (+38 +/- 18/+24 +/- 1 3 mm Hg) than in those with essential hypertension (+21 +/- 8/+13 +/- 6 mm Hg). These differences also were statistically significant in con trolling for the effects of age and baseline blood pressures. These da ta suggest that mental arithmetic testing may be a useful tool for the diagnosis of white coat hypertension. (C) 1998 American Journal of Hy pertension, Ltd.