Differentiate white coat hypertension from masked hypertension.

• A. White coat hypertension shows elevated readings in clinic but normal at home; masked hypertension shows normal clinic readings but elevated readings outside the clinic.
• B. White coat hypertension shows elevated readings both in clinic and at home; masked shows normal readings both places.
• C. White coat hypertension is a myth; both signs are measurement errors.
• D. White coat hypertension is seen only in pediatric patients.

Answer: (A)

The main idea here is how blood pressure patterns differ between encounters in a clinic setting and measurements taken outside the clinic. White coat hypertension happens when a patient’s blood pressure is elevated in the clinical environment—likely due to anxiety or stress—while home or ambulatory readings are normal. This means the high reading is situational and not reflective of the patient’s typical blood pressure.

Masked hypertension is the opposite scenario: clinic measurements appear normal, but out-of-clinic readings are elevated. This is particularly important because it can go unnoticed if only clinic measurements are used, potentially delaying treatment for a real hypertensive state.

The described pattern in the question—elevated in the clinic but normal at home, and normal in the clinic but elevated outside—fits these definitions precisely. The other statements are inconsistent with established phenomena: hypertension that’s high in both settings isn’t white coat or masked hypertension, calling it a myth ignores solid evidence, and the idea that it’s seen only in children isn’t accurate.