White coat syndrome: What is it and do you have it?

If you are one of those people who find their blood pressure is normal at home, but seems to rise when they visit the doctor, you could have white coat syndrome (also known as the white coat effect). It’s a condition that gets its name from doctors and medical staff who sometimes where white coats.

In case you were wondering, your blood pressure is considered healthy if it reads around 120/80 mm Hg. If it is above this, say 140/90 mm Hg for example, it is considered to be in the high blood pressure category.

The first number represents your systolic pressure when the heart beats. The second number represents the diastolic pressure when the heart rests. If only one number is elevated, you still have high blood pressure with all of its dangers.

While white coat syndrome can make your blood pressure reading higher than it would normally be, the effect isn’t always a minor issue and it doesn’t always have something to do with medical professionals. This condition could be a sign of something more serious with your blood pressure.

High blood pressure — hypertension — can be sneaky. It is often regarded as a silent killer because often there are no symptoms.

White coat syndrome is high blood pressure that occurs when you see your doctor or other medical professional. It does not occur in another setting. This is how you can tell the difference between white coat syndrome and regular high blood pressure.

What causes white coat syndrome?

First of all, it is completely normal to experience some anxiety when you visit your doctor. However, for some people it might trigger this medical phenomenon.

It is estimated that between 15 and 30 per cent of people who have high blood pressure in a medical setting have white coat syndrome.

Occasional high blood pressure can also be caused by work stresses, an emergency situation, and not taking your blood pressure medication for an extended period of time.

The danger in these circumstances is that your doctor might unnecessarily treat you for hypertension, but also it might mistakenly have your doctor thinking that a successful treatment is not working.

Further, a study published in the Journal of the American College of Cardiology found that those who suffer from white coat syndrome have increased risk of stroke, heart attack, heart failure and other cardiovascular conditions.

It is therefore crucial that a diagnosis is accurate when deciding if you need treatment for elevate blood pressure.

Temporary increases in your blood pressure — regardless of whether it is caused by someone in a white coat or not — can place your heart under strain and cause it damage.

How is white coat syndrome diagnosed?

If you have a high blood pressure reading, your doctor might ask for you to repeat the test at a later date or over a period of weeks. If you are concerned that going to your doctor’s office might result in another incident of anxiety about having your blood pressure taken, you can request for the test to be done away from the professional offices. This might involve having a home blood pressure monitor, or it could involve you having an ambulatory blood pressure monitor where you are strapped to a device and your blood pressure it tracked every 20-30 minutes over a period of a day or two.

How you can treat white coat syndrome

There are many different approaches to treating this very real syndrome.

If sitting down to have your blood pressure taken causes you to feel anxious or worried, you can ask the doctor or nurse to wait a little bit before they take the reading, which will give you an opportunity to calm down.

If you are a smoker, you might want to avoid having a cigarette within 30-45 minutes before your blood pressure is taken.

Some medical professionals recommend you avoid drinking coffee or caffeinated drinks before a blood pressure test, that you empty your bladder before a test (because a full bladder might affect the reading), and that you sit quietly before the test. This last one might mean you move to a quiet area away from the noise of the doctor’s office so that you can calm your nerves.

While it can be nerve wracking to visit the doctor, and while an increase in your blood pressure isn’t always a sign of a big issue, it is something you should keep an eye on. Always talk to your health care professional to ensure diagnosis and treatment is right for you.

Have you ever been worried about your blood pressure? How do you feel about having to visit medical practitioners?