If you've been to your doctor and your blood pressure was higher than normal, you could be experiencing a phenomenon known as white coat high blood pressure. This is a relatively common condition that can be quite alarming to patients who believe this reading represents a full blown case of hypertension. This condition is more commonly seen in high stress individuals who tend to become anxious in a medical environment.
What exactly is white coat high blood pressure and is it a cause for concern? White coat hypertension is a phenomenon where a blood pressure taken in a doctor's office or other medical setting is elevated but is completely normal when monitored at home. It's thought that when a patient is surrounded by medical personnel in white coats it activates a stress response that elevates the blood pressure temporarily. When the patient returns home and is in a relaxed state, the blood pressure returns to a normal level. Whether or not white coat high blood pressure is a cause for concern is open to debate.
Most doctors typically advocate that patients with white coat hypertension do home blood pressure monitoring for several weeks at various times of the day to get a more accurate reflection of their average blood pressure reading. If these values are normal, most would not initiate high blood pressure treatment. Although this perspective makes sense, a study published in the journal Lancet in 1996 showed that white coat high blood pressure could be an early indicator of heart disease. Patients in the study who manifested white coat high blood pressure also had abnormalities of the heart that were typical of those with more established hypertension.
Despite this study, there is still no consensus as to whether to treat white coat high blood pressure. If white coat hypertension is truly a marker for early hypertension and hypertension related heart disease, prompt treatment could potentially prevent the onset of complications. On the downside, antihypertensive medications are not without their own risks and side effects, making the decision to treat white coat high blood pressure a complicated one.
Some doctors are now recommending close monitoring of patients with white coat high blood pressure through home blood pressure measurements as well as repeated in-office readings. If you have had elevated blood pressure readings at your doctor's office, make the small investment in a blood pressure monitoring kit and take blood pressure readings three times a day for several weeks. Record each blood pressure in a book and show them to your doctor. This can be very useful information as far as making a treatment decision. Don't be too quick to dismiss an elevated blood pressure reading as just “nerves”. Take action and find out whether you have need treatment. It could save your heart.
