{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:54:45Z","timestamp":1791172485357,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Office blood pressure (OBP) may be transiently elevated during clinical encounters because of situational anxiety and stress\u2010related physiologic arousal, contributing to diagnostic uncertainty and potential overtreatment. Virtual reality (VR)\u2010based relaxation can reduce stress\u2010related physiologic responses, but its effects on OBP and potential role in mitigating the white coat response among patients undergoing ambulatory blood pressure monitoring (ABPM) have not been evaluated. We conducted a prospective, single\u2010arm, pre\u2010post study among adults undergoing ABPM in a tertiary hypertension clinic. Participants completed paired OBP measurements and validated anxiety assessments before and after a brief immersive VR relaxation experience. ABPM results were used to classify predefined blood pressure subgroups. Seventy\u2010eight participants completed the study (mean age 62 \u00b1 15 years; 47% female). Across the cohort, systolic OBP decreased by 6.1\u00a0mmHg (95% CI, \u22127.6 to \u22124.6;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and diastolic OBP by 1.4\u00a0mmHg (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) following VR exposure. Participants with a pronounced white coat response, prespecified as an office\u2010to\u2010daytime ambulatory systolic BP difference \u226515\u00a0mmHg, experienced the greatest systolic BP reduction (\u221212.2\u00a0mmHg;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), compared with smaller or nonsignificant changes in other subgroups (between\u2010group\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005). Following VR exposure, 32.1% of participants were reclassified to a lower OBP category. Anxiety scores decreased significantly, and no adverse effects were reported. A brief VR relaxation intervention was associated with significant reductions in OBP and anxiety, particularly among participants with a pronounced white coat response, supporting its potential as an adjunct for improving OBP assessment in hypertension clinics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>Clinical Trials. gov Identifier: NCT06960057<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jch.70360","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:32:48Z","timestamp":1789108368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Virtual Reality Reduces Office Blood Pressure and Anxiety in Patients Undergoing Ambulatory Blood Pressure Monitoring: Enhanced Response among Those With a Pronounced White Coat Response"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4937-8357","authenticated-orcid":false,"given":"Lyle Wesley","family":"Baker","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Jacksonville Florida USA"},{"name":"Medical Director of Mayo Clinic Comprehensive Hypertension Center  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8159-3038","authenticated-orcid":false,"given":"Rohith","family":"Karthik","sequence":"additional","affiliation":[{"name":"Clinical Research Internship Study Program Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1298-603X","authenticated-orcid":false,"given":"Vinay R.","family":"Munlapudi","sequence":"additional","affiliation":[{"name":"Clinical Research Internship Study Program Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5406-0663","authenticated-orcid":false,"given":"Jonathan","family":"Balog","sequence":"additional","affiliation":[{"name":"Division of Regional Medicine Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-7003","authenticated-orcid":false,"given":"Michael A.","family":"Mao","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6762-4999","authenticated-orcid":false,"given":"Christopher L.","family":"Trautman","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-8029","authenticated-orcid":false,"given":"Yaohua","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4745-4745","authenticated-orcid":false,"given":"Zhihui Judy","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-8548","authenticated-orcid":false,"given":"Ivan E.","family":"Porter","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv157"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000249"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra060433"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01275"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19\u20100223"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.9.2.209"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126097\u2010200212000\u201000001"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S77710"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.16.2192"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03720020027031"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2010.203"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872\u2010200106000\u201000004"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171700040X"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/17449871241252005"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2024.07.012"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2024.11.014"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916\u2010024\u201001308\u20105"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2024.10.007"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.66299"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241272604"},{"issue":"3","key":"e_1_2_13_22_1","first-page":"249","article-title":"Can a Five\u2010Minute Virtual Reality Headset Intervention Reduce Blood Pressure in Patients With White\u2010Coat Hypertension?","volume":"16","author":"Milon R.","year":"2024","journal-title":"International Journal of Exercise Science: Conference Proceedings"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2021.103721"}],"container-title":["The Journal of Clinical 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