Have you noticed that your blood pressure is consistently higher at your
doctor’s office than it is in your home? You could be experiencing
what’s known as White Coat Hypertension.
White Coat Hypertension – also commonly referred to as White Coat
Syndrome – occurs when patients have a notably higher blood pressure
while visiting a physician than they have in non-clinic settings. “Sometimes
the difference between in-office and at-home blood pressure readings is
upwards of 15 to 20 points, while showing no other physical symptoms,” notes
Peter Arellano, MD, MPH, a board-certified family medicine physician at
Queen of the Valley Medical Associates in Napa.
It’s fairly common for people with otherwise normal blood pressure
to experience a serious spike in their reading as a result of anxiety
or fear of doctors – hence the name “White Coat Syndrome.”
In a study by the University of Exeter Medical School of more than 1,000
patients, blood pressure readings made by doctors were, on average, 7/4
mmHg higher than those made by nurses.
Diagnosis can be extremely difficult, because it’s hard to establish
a baseline blood pressure when the patient is consistently in a hypertensive
state while in a clinical setting. If you suspect that you’re experiencing
White Coat Syndrome, it’s important that you measure your blood
pressure at home in a variety of settings, as it can increase or decrease
over the course of the day based on a number of factors. “You need
to know if you’re blood pressure is actually consistently high,
or if your numbers are anxiety-provoked, as this will affect your treatment
plan, if one is necessary at all,” Dr. Arellano says.
To check your blood pressure at home, you can purchase a small manual or
digital blood pressure monitor at your local drug store. First, you’ll
need to rest for 5 to 10 minutes with your arm at heart level, then sit
up straight with your legs uncrossed and feet flat on the ground. Rest
your arm on a table, palm facing up, and then proceed to follow the instructions
for your specific blood pressure monitor.
“It’s best to take your blood pressure from your left arm first
thing in the morning before eating or exercising,” says Dr. Arellano.
“Record your results, then repeat two more times, for a total of
three readings, to determine an accurate resting blood pressure.”
According to the American Heart Association, the upper limit for a healthy
blood pressure reading is 135/85.
Even if you’re not aware of your body’s subconscious reaction
to the thought of seeing a doctor, the anxiety is enough to physically
manifest as not only a situational high blood pressure, but also a long-term
health issue. White Coat Syndrome used to get written off as being a not-so-serious
case of nerves, but recent research suggests that upwards of 50 percent
of patients experiencing this situational hypertension eventually develop
established hypertension over time.
Before jumping right to a regimen of prescription medications, it’s
recommended that you start by taking steps to lower your blood pressure
naturally. You can lower your blood pressure with small lifestyle changes,
like eating a healthier diet, exercising more, and limiting your alcohol
intake. Keep tabs on your blood pressure at home to determine if your
lifestyle changes are making a notable difference, and communicate with
your doctor throughout the process to discuss whether a stronger course
of action is required.
“It’s possible that White Coat Hypertension can be an early
warning sign that a patient is at a higher risk of developing a long-term
high blood pressure condition,” says Dr. Arellano. “Be sure
to get your blood pressure checked regularly so you and your physician
can monitor the changes and patterns in your readings over time.”
Do you get nervous having your vital signs taken at the doctor’s
office? Share a comment below.
Learn more about
Dr. Arellano. Learn more about
Queen of the Valley Medical Associates.