White coat syndrome is the name given to a disorder in which a person develops high blood pressure when they are around doctors, who often wear white coats.
Some people who usually have normal blood pressure find that it spikes when they visit the doctor. This condition is called white coat hypertension or the white coat effect. While white coat syndrome may make the blood pressure read higher than it is, the effect may be a sign of an underlying blood pressure condition.
A thorough diagnosis is vital to begin any necessary treatments.
Hypertension or high blood pressure is a condition where the force of the blood against the walls of the arteries in the body is too high.
Normal blood pressure levels are around 120/80 millimeters of mercury (mmHg). Doctors usually define hypertension as a blood pressure reading of anything above 140/90 mmHg.
According to the Centers for Disease Control and Prevention (CDC), about 32 percent of American adults have high blood pressure.
While the exact causes of high blood pressure are not known, there is a variety of factors that can increase the risk of hypertension, such as:
- lack of physical activity
- lifestyle choices, such as smoking or drinking too much alcohol
- a high-stress lifestyle
- too much salt intake
- a family history of high blood pressure
- older age
- thyroid disorders
- sleep apnea
- kidney disease
Managing these risk factors may help some people keep their blood pressure in the healthy range.
However, white coat hypertension is high blood pressure that typically occurs only at the doctor's office or other medical center and may have something to do with nervousness or anxiety surrounding the office.
A recent study posted to the journal Hypertension noted that somewhere between 15 and 30 percent of people with high blood pressure at the doctor's office might be affected by white coat hypertension.
While white coat hypertension may cause a spike in the blood pressure, not all doctors are convinced this is the only cause of a person's high blood pressure.
Some believe white coat hypertension is a precursor to actual hypertension.
Stress and anxiety may play a role in high blood pressure, so people with white coat hypertension may still be more at risk for issues caused by blood pressure.
In fact, a study posted to the Journal of the American College of Cardiology found that people who had white coat hypertension were also more likely to experience cardiovascular issues.
It is essential, therefore, that doctors find a way to accurately diagnose a person's blood pressure and start any treatment that is necessary.
Treating white coat syndrome
Treating white coat syndrome can be tricky, as it can be hard for doctors to get an accurate reading of the blood pressure to determine if someone has hypertension.
Typically, doctors do not prescribe chemical medicines to treat someone with high blood pressure based on one high reading. This could lead to problems, such as hypotension, where a person's blood pressure drops too low, which causes its own set of issues.
Instead, doctors will want to take multiple readings. They may refer individuals to a blood pressure clinic, or ask them to use an at-home blood pressure monitor. A proper diagnosis is crucial to help treat or prevent hypertension.
Diagnosing someone with white coat syndrome may be challenging, as it is often difficult to get an accurate reading. If the initial reading is high, a doctor will typically ask the person to come back in a few weeks for another reading. However, a person who has white coat syndrome is likely to experience high blood pressure the second time.
In these cases, doctors may recommend that the person take their blood pressure readings somewhere else, using a home blood pressure monitor or an ambulatory blood pressure monitor. An ambulatory blood pressure monitor is a device that a person typically wears for 1 or 2 days.
The device measures the blood pressure at various times throughout the day. The difference between the machines may just be a matter of personal choice. These monitors allow the user to take their blood pressure readings from the comfort of their own home and send the results to their doctor.
Worrying over whether or not the blood pressure will spike may be enough to cause the blood pressure to spike during the reading.
Trying some of the following may help prevent white coat syndrome:
Some relaxation techniques, such as breathing exercises or meditation may help people who are worried about their blood pressure to calm down before going into the doctor's office.
One exercise involves counting things using the senses. For instance, a person could count three things they can see in the room, two things they can hear, and one thing they can touch. This exercise may help the person focus less on what is worrying them and more on what is around them.
Move if necessary
A doctor's office can be an intimidating place filled with nurses, receptionists, and doctors all busy going about their routine. Anyone affected by this activity could ask to move to a quiet room.
Take a moment
If still feeling nervous when it is their turn to see the doctor, a person might stop and take a moment to relax. Taking a few deep breaths may help calm the nerves. Relaxing for a few moments may help give a more accurate reading.
The primary complication of white coat syndrome is hypertension itself. Many people may believe that a fear of doctors or anxiety about the office visit causes their high blood pressure. However, the current research indicates that white coat syndrome may be an indication of future hypertension.
A thorough diagnosis is key to understanding what is causing the hypertension. Managing stress and anxiety levels may help in some cases so the doctors can get a good reading of a person's blood pressure.
White coat syndrome may put a person at risk for cardiovascular issues, and not all doctors think the condition is harmless. Anyone who thinks they have white coat hypertension should see a doctor for a thorough diagnosis.
Some people may need to take their blood pressures at home; others may be referred to a blood pressure clinic where they will undergo multiple tests over a period.