Differences Between Masked Hypertension and White Coat Hypertension
High blood pressure can feel like a hidden puzzle. Two pieces of that puzzle—masked hypertension and white coat hypertension—behave in opposite ways and can mislead both you and your clinician. Understanding the differences helps you manage your health with confidence.
High blood pressure can feel like a hidden puzzle. Two pieces of that puzzle—masked hypertension and white coat hypertension—behave in opposite ways and can mislead both you and your clinician. Understanding the differences helps you manage your health with confidence.
Hypertension at a Glance
Blood pressure measures how hard your blood pushes against artery walls. Readings show:
Systolic (upper number): pressure when the heart beats
Diastolic (lower number): pressure between beats
Keeping both numbers within the healthy range protects your heart, brain and kidneys.
What Is White Coat Hypertension?
Featured-snippet answer: White coat hypertension happens when your blood pressure rises in a medical setting but stays normal during everyday life.
Why it occurs
Anxiety about tests or results
Unfamiliar surroundings or equipment
Anticipation of pain, needles or bad news
How it is confirmed
Normal readings with home or ambulatory monitors
Consistent spikes only in the clinic
Untreated, white coat hypertension can evolve into persistent high blood pressure over time.
What Is Masked Hypertension?
Featured-snippet answer: Masked hypertension is the opposite pattern—office readings look normal, but your blood pressure runs high at home or work.
Why it occurs
Daily stress that disappears in the clinic
Smoking, alcohol or excess caffeine
Poor sleep or shift work
High-salt diet and low activity
How it is confirmed
Normal in-office measurements
Elevated readings with home or 24-hour monitors
Because it hides behind “normal” check-ups, masked hypertension carries a higher risk of silent organ damage.
Prevalence & Risk Factors
Pattern
How common?*
More likely if…
White coat
15–30 %
You feel anxious in clinics; you are older or female
Masked
10–20 %
You are younger, male, under daily stress, smoke, or sleep poorly
*Estimates vary by study.
Shared risk factors for both patterns include a family history of hypertension, sedentary lifestyle and diets high in salt or processed foods.
Symptoms & Diagnosis
Most people notice no obvious symptoms. Occasional headaches, dizziness or fatigue can occur but are unreliable clues. For both patterns, the gold standard is out-of-office monitoring:
Move more: aim for 150 minutes of moderate activity each week.
Limit alcohol and quit smoking.
Prioritise quality sleep (7–9 hours for most adults).
Practise stress management: deep breathing, mindfulness or gentle yoga.
Extra Steps for White Coat Hypertension
Use relaxation techniques right before and during the appointment.
Ask for manual re-checks after a few minutes of rest.
Share home readings to avoid unnecessary medication.
Extra Steps for Masked Hypertension
Log your blood pressure at different times and on workdays.
Review triggers such as caffeine, shift work or high-stress meetings.
Medications may be needed earlier because daily pressure is truly high.
Technology Today—and Tomorrow
Modern Bluetooth-enabled monitors sync readings to your phone, letting you and your clinician spot patterns quickly. Emerging wearables may soon offer round-the-clock pressure trends, alerting you before problems arise.
Key Takeaways
White coat hypertension = high in clinic, normal at home.
Masked hypertension = normal in clinic, high at home.
Both require home or ambulatory monitoring for accurate diagnosis.
Early lifestyle changes—and medication when prescribed—protect your heart, brain and kidneys.
At OMRON Healthcare, we believe that clear information and reliable technology empower you to live life to the fullest.
This content has been reviewed and approved by a Omron Healthcare Europe cross-functional team to ensure that the provided information is accurate. Approval Code: OHEAPP-897
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