Serum cortisol in the white-coat phenomenon

Ikuo Saito, Eiko Takeshita, Kazuko Murata, Hiroshi Kawabe, Takao Saruta

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The rise in blood pressure associated with a clinic visit (the white-coat phenomenon) may result from anxiety or an alerting reaction. There is evidence to suggest that glucocorticoids may be involved in the mechanism of stress-related blood pressure elevation, but the relationship between the white-coat phenomenon and glucocorticoids has not been assessed. Design: Forty-eight young subjects with essential hypertension were compared with 12 control normotensive subjects. Methods: Home blood pressure monitoring for 7 days and serum cortisol at 0900 h and 2 h rest at 1100 h were measured. The white-coat phenomenon was calculated for systolic and diastolic blood pressures as the difference between clinic blood pressure and average home blood pressure. Results: The serum cortisol level was significantly greater at 0900 h than that at 1100 h in the hypertensive subjects and was higher in the hypertensive subjects than in the normotensive subjects (21.5 ± 0.5 versus 14.3 ± 0.9 mu;g/dl), but there was no difference between serum cortisol levels at 1100 h in the two groups. The magnitude of the white-coat phenomenon, which was greater in the hypertensive subjects than in the normotensive group (22 ± 2/12 ± 1 versus 4 ± 3/1 ± 3 mmHg), correlated with serum cortisol at 0900 h, but not at 1100 h. The higher level of serum cortisol at 0900 h was confirmed by another measurement conducted 4 months later in a subsample of the hypertensive subjects (n = 18). Conclusions: These results suggests that the white-coat phenomenon is related to the transient increase in serum cortisol or psychological stress, or both, which can trigger arousal of the hypothalamic pituitary adrenocortical axis.

Original languageEnglish
Pages (from-to)381-383
Number of pages3
JournalBlood Pressure Monitoring
Volume1
Issue number4
Publication statusPublished - 1996

Fingerprint

Hydrocortisone
Blood Pressure
Serum
Glucocorticoids
Ambulatory Blood Pressure Monitoring
Ambulatory Care
Arousal
Psychological Stress
Anxiety

Keywords

  • Cortisol
  • Home blood pressure
  • Stress
  • White-coat phenomenon

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Saito, I., Takeshita, E., Murata, K., Kawabe, H., & Saruta, T. (1996). Serum cortisol in the white-coat phenomenon. Blood Pressure Monitoring, 1(4), 381-383.

Serum cortisol in the white-coat phenomenon. / Saito, Ikuo; Takeshita, Eiko; Murata, Kazuko; Kawabe, Hiroshi; Saruta, Takao.

In: Blood Pressure Monitoring, Vol. 1, No. 4, 1996, p. 381-383.

Research output: Contribution to journalArticle

Saito, I, Takeshita, E, Murata, K, Kawabe, H & Saruta, T 1996, 'Serum cortisol in the white-coat phenomenon', Blood Pressure Monitoring, vol. 1, no. 4, pp. 381-383.
Saito I, Takeshita E, Murata K, Kawabe H, Saruta T. Serum cortisol in the white-coat phenomenon. Blood Pressure Monitoring. 1996;1(4):381-383.
Saito, Ikuo ; Takeshita, Eiko ; Murata, Kazuko ; Kawabe, Hiroshi ; Saruta, Takao. / Serum cortisol in the white-coat phenomenon. In: Blood Pressure Monitoring. 1996 ; Vol. 1, No. 4. pp. 381-383.
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