White Coat Hypertension

What is White Coat Hypertension?

Have you ever measured your blood pressure at home, and it looks fine but then at the doctor’s office, it’s through the roof? (super high). You may be experiencing White Coat Hypertension. It was given that name because of the white coat that some healthcare professionals wear. It’s possible that for some people, just being in the doctor’s office can cause greater stress which can cause blood pressure to go up.

That happened to me a lot. It was frustrating, honestly. I mean, what do I even do with that information? It’s hard for me to calm down at the doctor’s office. How do I know if I have high blood pressure? Or if I’m just nervous?

What are some options if you think you have White Coat Hypertension?

Well first, it’s important not to dismiss the higher numbers as nothing. Better to do a little investigating to figure out what might be going on. Hey if it turns out to be just White Coat Hypertension, yay! If it turns out you have high blood pressure, well now you know and can make a plan with your doctor to address it.

4 Things You Can Try

  1. Ambulatory Blood Pressure Monitor: It requires a doctor’s order to do this test (my cardiologist ordered this test). A blood pressure cuff is placed on your arm and it’s attached to a small portable monitor. It measures your blood pressure throughout a 24-hour period and then creates a report for your doctor to look at. It’s a way of seeing how your numbers look during a longer period of time, especially out of the doctor’s office, away from that White Coat Hypertension stress.
  2. Learn the proper way to take blood pressure: Another common step is to start taking blood pressure at home so you can see what the numbers look like outside the doctor’s office. It’s important to know how to take blood pressure according to standards recommended by the medical community. It helps you to provide the most accurate numbers to your doctor. Take a look at my tutorial on how to take blood pressure and the many factors that can affect blood pressure.
  3. Ask for What You Need at the Appointment: Once you know how to properly take blood pressure, it might be good to work on advocating for yourself at the doctor’s office as well when they are taking your blood pressure. For example: if you just rushed in, it’s okay to ask to have a repeat blood pressure measurement after you’ve had a few minutes to catch your breath! I want to emphasize from my experience, it’s often about how you approach the communication with the nurse or medical assistant. I like to explain: “My blood pressure tends to run a bit high when I first get in, and I’m feeling a bit nervous. Can you take it in 5 minutes?” Many well-meaning medical folks are dealing with very busy schedules and high pressures at work, I recommend being kind and polite when asking for what you need, but do ask, as it is important to advocate for your health. Another example is: if the medical assistant is making conversation or asking you questions while they are taking your blood pressure, it’s okay to say “Do you mind if we talk after the blood pressure? It just helps me stay calm to take a moment quietly.” Blood pressure can be affected by talking too! It can be awkward to make these requests, but again, it’s about the approach.
  4. Bring Your Blood Pressure Monitor to the Doctor’s Office: These days, with blood pressure home monitors widely available for sale online and in stores, there is much variation in what everyone is using. One good strategy is to bring your monitor to the doctor’s office for comparison. What I mean is: after the medical assistant takes your blood pressure, make a note of their numbers. Then, use your own machine and take it as well. I recommend sharing the result with your doctor and see if they think the 2 sets of number are close enough. I wouldn’t want you to work hard taking your blood pressure at home all day, only to have a machine that might be way off! What if my doctor is too busy for me to get an appointment? One possible option is to ask the front desk staff if they do nurse visits. Some medical offices may allow this as an option if you’re just looking to compare your machine to theirs. 

References:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/white-coat-hypertension/faq-20057792

https://www.heart.org/en/news/2020/05/22/how-to-accurately-measure-blood-pressure-at-home

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