- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
Definition (3)
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Risk factors (2)
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Symptoms (1)
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Causes (5)
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Complications (1)
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Treatments and drugs (7)
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Lifestyle and home remedies (11)
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Alternative medicine (2)
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Question
White-coat hypertension: When blood pressure rises at the doctor's office
My blood pressure is always higher in the doctor's office than when I measure it at home. Why is this?
Answer
from Sheldon G. Sheps, M.D.
You could have "white coat hypertension." White coat hypertension occurs when the blood pressure readings you have measured at your doctor's office are higher than they are when measured in other settings, such as your home. It's called white coat hypertension because the health care professionals who measure your blood pressure sometimes wear white coats.
It was thought that white coat hypertension was caused by the stress that doctor's appointments can create. Once you'd left the doctor's office, if your blood pressure normalized, there wasn't a problem.
However, some doctors think that white coat hypertension might signal that you're at risk of developing high blood pressure as a long-term condition. The same may also be true for people who have masked hypertension, meaning their blood pressure is normal at the doctor's office, but spikes periodically when measured in other settings. It's thought that even temporary increases in your blood pressure could develop into a long-term problem.
If you have white coat hypertension, talk to your doctor about home monitoring of your condition. This can help determine if your high blood pressure only occurs in the doctor's office, or if it's a persistent condition that needs treatment.
Next questionAlcohol: Does it affect blood pressure?
- Mancia G, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226.
- Pierdomenico SD, et al. Prognostic value of white-coat and masked hypertension diagnosed by ambulatory monitoring in initially untreated subjects: An updated meta analysis. American Journal of Hypertension. 2011;24:52.
- Niiranen TJ, et al. Home-measured blood pressure is a stronger predictor of cardiovascular risk than office blood pressure: The Finn-Home Study. Hypertension. 2010;55:1346.
- Myers MG, et al. Measurement of blood pressure in the office: Recognizing the problem and proposing the solution. Hypertension. 2010;55:195.
- Kaplan NM. Ambulatory blood pressure monitoring and white coat hypertension in adults. http://www.uptodate.com/home/index.html. Accessed May 19, 2011.
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