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White-coat hypertension — MCCQE Part 1 MCQ

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HardHypertensionWhite-coat hypertensionMCCQE Part 1

A 49-year-old woman has office BP 150/92 mmHg but validated home readings averaging 122/76 mmHg and no target-organ damage. Which of the following is the most appropriate next step?

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Correct answer: C — Diagnose likely white-coat hypertension and continue periodic monitoring and lifestyle advice

Diagnose likely white-coat hypertension and continue periodic monitoring and lifestyle advice is the single best answer because the age, timing, examination findings and investigations in the vignette fit White-coat hypertension better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Hypertension Canada 2025, with attention to acuity, safety-netting and local provincial pathways.

Reference: Hypertension Canada 2025