title: Is white coat hypertension a concern in Mohs micrographic surgery?
abstract: OBJECTIVE
  To examine white coat hypertension (WCHTN) in patients presenting for Mohs micrographic surgery (MMS) to determine whether it should be a concern.
  
  
  METHODS
  In this prospective study, blood pressure (BP) was recorded in 100 consecutive patients who presented for MMS consultation and a subsequent MMS procedure, and compared on both days. Statistical analysis was performed using the paired Student t test and the significance of the findings was determined based on the corresponding P values. Progression from normotensive to hypertensive state while the doctor was in the room was stratified based on the patient's age, gender, and histories of smoking, hypertension (HTN), diabetes, and hyperlipidemia; as well as whether the doctor was wearing a white lab coat over blue surgical scrubs (50 patients) or blue surgical scrubs alone (50 patients).
  
  
  RESULTS
  BP increased from baseline when the doctor entered the room and then decreased towards baseline after five minutes of the doctor being present. Elevation in BP was more evident in younger people, males, and those with HTN and hyperlipidemia. BP was slightly higher on the day of the consultation than on the day of the procedure. A higher number of patients became hypertensive when the doctor wore a white lab coat over blue surgical scrubs vs blue surgical scrubs alone. However, these changes in BP did not prove to be statistically significant.
  
  
  CONCLUSIONS
  Brief periods of WCHTN were seen on both days. However, these elevations in BP were not statistically significant and decreased towards baseline after five minutes. There were no cases in which elevation in BP associated with WCHTN was sufficient to result in the need to postpone or cancel MMS.
authors.affiliation: Skin Cancer and Aesthetic Surgery Center, New York, NY, USA. drvergilis@gmail.com
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Vergilis-Kalner
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003020:Clothing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors; D013997:Time Factors; D059466:White Coat Hypertension / Q000453:epidemiology*