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White coat hypertension — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareWhite coat hypertensionUSMLE Step 3

A 57-year-old woman has office blood pressures around 156/90 mm Hg but brings a validated home log averaging 124/76 mm Hg. She feels anxious in clinic. No end-organ injury is found. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: B — White coat hypertension

Elevated clinic readings with normal out-of-office readings are consistent with white coat hypertension.

Reference: 2025 AHA/ACC High Blood Pressure Guideline