How is white coat hypertension detected clinically? For those with office blood pressure ≥140/90 mmHg, first, home blood pressure monitoring can be used. Blood pressure is measured twice a day using a qualified upper-arm electronic sphygmomanometer, preferably at the same time period, three times, with an interval of 1 min, taking the average value and keeping records for 7 d; if the blood pressure is normal it can be diagnosed as white coat hypertension. Second, 24h ambulatory blood pressure monitoring can be used. If the office blood pressure is ≥140/90 mmHg and the daytime ambulatory blood pressure is <135/85 mmHg, it can also be diagnosed as white coat hypertension. Home blood pressure monitoring plays a key role in the clinical detection and management of hypertension, is more convenient and less costly than 24h ambulatory blood pressure monitoring, and facilitates ready and long-term monitoring. After the first discovery of the white coat phenomenon by Manicia back in 1983, it once sparked a heated debate in the academic community. Some scholars believe that it is a temporary reactive increase in blood pressure caused by psychological factors in a specific medical setting, which is benign hypertension, and some call it "pseudohypertension" and consider it unnecessary to treat. Another group of scholars, through in-depth research, believes that people with white coat hypertension have a higher risk of developing hypertension in the future, and that white coat hypertension is often accompanied by metabolic disorders such as lipid and blood glucose, and can also increase the thickness of the carotid intima, which can damage target organs such as the heart, brain and kidney to some extent. It was previously thought that white coat hypertension was associated with mental stress in patients in a medical setting, but in recent years, a growing number of studies have shown that white coat hypertension is actually a sign of possible future heart disease. Studies have shown that people with white coat hypertension can have a 38% increased risk of cardiovascular disease and a 20% increased risk of death compared to those with normotension. Management of white coat hypertension: White coat hypertension is very common clinically, but not completely benign. Studies show that nearly half of white coat hypertension will develop into persistent hypertension within 10 years. Therefore, white coat hypertension should be intervened as early as possible. The first step is lifestyle changes, including quitting smoking, limiting alcohol consumption, improving dietary structure, eating more vegetables and fruits; and strengthening exercise to control or reduce body mass. One of the priorities in the treatment of white coat hypertension should be how to avoid or delay the development of white coat hypertension into persistent hypertension. An important mechanism in the development of white coat hypertension is sympathetic hyperexcitability, so if the 24h dynamic mean heart rate is >80 beats/min, suggesting sympathetic hyperexcitability, β-blocker therapy can be considered. In addition, for people with white coat hypertension combined with diabetes, target organ damage or other cardiovascular disease risk factors, antihypertensive drug therapy should also be considered, but should be done carefully to avoid overkill, otherwise cardiovascular and cerebrovascular ischemic events may occur due to insufficient blood perfusion of important organs caused by excessive blood pressure lowering. For people with combined glucose and lipid metabolism, simultaneous glucose control and lipid regulation therapy is required.