Issn Print: 0263-6352

Publication Date: 2002/08/01


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Reversed white-coat hypertension: not what it seems

J. I. S. Robertson

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I opened the April issue of the Journal of Hypertension with considerable interest. The list of contents, as printed on the front cover, promised an account of a syndrome of which I was previously unaware, ‘reverse white-coat hypertension’ [1]. Moreover, there was also an editorial commentary on this intriguingly bizarre phenomenon. That editorial account was even more specifically entitled ‘reversed white-coat hypertension’ [2].
I could well envisage that susceptible subjects would show distinct elevation of arterial pressure at the distressing apparition of a medical attendant wearing a white coat back to front. Even so, the occurrence seemed likely to be insufficiently frequent to be of major epidemiological significance, even in Australia, whence the report came. Then again, this might be a belated and extended response to Aldous Huxley's injunction to parsons, that they should be distinguished from the rest of the population by wearing not just their collars, but all their garments, reversed.
Sadly, the report [1] was not concerned with any reversal of white coats. The title comprised simply an unhappy convolution of the disagreeable jargon phrase ‘white-coat hypertension'. Interestingly, Mancia [2] cautions against the usage not because of its perversion of language but so as to avoid a rather different ‘conceptual inconsistency'.
This episode, which manages to excite concurrently hilarity and irritation, should serve to warn against the introduction of jargon into medical speech and writing. Evidently here the words have become wholly dislocated from their etymology and have, in the process, lost all semantic content.

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