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Original Articles: Federico A. Augustovski, Cecilia B. Calvo, Matías Deprati, and Gabriel Waisman The Deep-Breath Test as a Diagnostic Maneuver for White-Coat Effect in Hypertensive Patients J Am Board Fam Pract 2004; 17: 184-189 [Abstract] [Full text] [PDF]

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Consideration for “Circumstancial Hypertension”.

Dr. Rajesh Chauhan. MBBS, DFM, ADHA, FCGP, FISCD, FAIMS., Dr. Akhilesh Kumar Singh, MD; Dr. Parul (Chauhan) Kushwah, MBBS, MISMCD.   (9 December 2005)

Consideration for “Circumstancial Hypertension”. 9 December 2005
Dr. Rajesh Chauhan. MBBS, DFM, ADHA, FCGP, FISCD, FAIMS., Consultant, Family Medicine & Communicable Diseases 309/9 A.V. Colony, Sikandra, Agra. INDIA, Dr. Akhilesh Kumar Singh, MD; Dr. Parul (Chauhan) Kushwah, MBBS, MISMCD. Send response to journal: Re: Consideration for “Circumstancial Hypertension”. drchauhanrajesh{at}yahoo.com Dr. Rajesh Chauhan. MBBS, DFM, ADHA, FCGP, FISCD, FAIMS., et al.	Dear Editor, Not getting a desired job despite long chase, getting a tiring one, disharmony at work or at home, unending frustrations, pending crisis, troubling events in rapid succession, barely able to make both ends meet, always fighting against time, having to provide patronage to handicapped or disabled with chronic illness, terminal illness in the family or of a loved one, etc, are certain circumstances that have the potentials to give rise to hypertension. This hypertension shall prevail till such time the ‘circumstances’ remain unchanged. This has been our observation over a period of time and such patients usually comprise almost 30-40%, or perhaps more, of all hypertensives. On careful evaluation, their condition and the precipitating circumstances will be apparent. However, with reversal of circumstances and sometimes with alternative modalities of therapy, magic, prayers etc, their blood pressures return to normal – with propensity to swing back to the raised levels when circumstances become unfavorable once again. The control of raised blood pressures is not so easy in this group of “Circumstancial Hypertension”. Such patients need special attention and their associated psychological problems and associated psychosomatic illnesses will have to be addressed. They have a tendency of flitting from one consultant to another, for their blood pressures are never controlled properly and their problems are not understood properly. Maybe, if we keep a eye on this group, while grading them and try managing them differently than that followed for the Essential (Primary) Hypertension, better outcomes are possible for this group. With warm regards. Reference: 1. Chauhan R, Singh AK, Chauhan P. ‘Circumstantial’ Hypertension. BMJ 5 Oct 2005. http://bmj.com/cgi/eletters/331/7516/533-a#118439, 5 Oct 2005