Dr. Anna Grandi and colleagues at the University of Insubria in Varese, Italy
warn that "White Coat" Hypertension is far more serious than previously 
thought.

No, it isn't a cure for cancer, but another important Medical Study emanates
from Italy. 

And again, it is an Italian Woman that is the center of attention, which 
further 
validates my continuing claim that Italy has the greatest number of highly 
placed and recognized women amongst all the European countries. I have 
yet to have anyone dispute that assertion.                                    
                            
=============================================
WHITE-COAT HYPERTENSION MAY BE HARMFUL

Chicago Daily Herald
Associated Press
December 10, 2001 

White-coat hypertension - blood pressure that's high only in the doctor's 
office - is not just a harmless case of the nerves but may signal early heart 
damage that should not be ignored, new research suggests.

The condition may require treatment either with diet and exercise or 
medication, Italian researchers say, entering a sharply divided field of 
medical opinion on just what white-coat hypertension signifies.

Several studies have addressed the issue over the past decade, with some 
researchers arguing that patients whose blood pressure is normal except 
during doctor visits probably are just anxious about seeing a physician.

The new study used heart imaging tests to compare white-coat patients with 
patients with true hypertension and those with normal blood pressure.

The tests focused on the heart's left ventricle, one of the lower 
blood-pumping chambers, which in white-coat patients showed early signs of 
cardiovascular disease, including enlargement and thicker walls. No 
enlargement was found in patients with normal blood pressure.

The study by Dr. Anna Grandi and colleagues at the University of Insubria in 
Varese, Italy, appears in today's edition of Archives of Internal Medicine.

Though the changes found in white-coat patients weren't as significant as 
those in patients with true hypertension, they suggest some strain is being 
put on the heart and indicate an increased risk of developing cardiovascular 
disease, including heart attacks, down the road, said Dr. Daniel W. Jones, 
hypertension director at the University of Mississippi Medical Center and an 
American Heart Association spokesman.

While the study is not the first to link the condition with heart 
abnormalities, it is perhaps the most convincing, Jones said.

"It's the strongest evidence that we have to date regarding office 
hypertension" and its risks, Jones said. "The evidence looks persuasive."

National Institutes of Health hypertension guidelines have no definitive 
recommendations for treating white-coat hypertension, leaving it up to 
doctors to decide whether to prescribe treatment, including medication, Jones 
said.

Jones said he generally recommends high blood pressure drugs for his patients 
with white-coat hypertension, and said he suspects the study will lead other 
doctors to do the same.

An Archives editorial said the study "doesn't settle the argument" but 
presents compelling evidence that the condition should be treated, not 
ignored.

Since treatment "usually does not involve complicated or dangerous regimens, 
it is good policy to treat white-coat hypertensives," Dr. Marvin Moser of 
Scarsdale, N.Y., said in the editorial.