Jakob Tobias Nyvad

A case of an extreme white coat effect

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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.

Original languageEnglish
JournalBlood Pressure
Pages (from-to)63-67
Number of pages5
Publication statusPublished - 2020

    Research areas

  • White-coat hypertension, anxiety, arterial pressure, blood pressure, cardiovascular diseases, hypertension, stroke, ANXIETY, RISK, HYPERTENSION, BLOOD-PRESSURE

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ID: 172716247