White Coat Hypertension

Some people experiencing elevated blood pressure in front of doctors or nurses (white coats) otherwise the blood pressure is normal considering as white coat hypertension/syndrome.

White-coat hypertension occurs in 15% to 30% of subjects with an elevated office blood pressure.

What causes white coat hypertension?

White coat effects often because of stress, nervous, or anxious about having your blood pressure tested by a doctor or nurse.

If you are anxious, systolic and diastolic blood pressure may rise to 30mmHg.

These causes are mostly due to the clinical environment. Many knowing have and feel their nervous or anxious. Few others unknowingly have this feeling.

What are the symptoms of white coat hypertension?

7 common white coat syndrome symptoms are:

1. Racing heart - or palpitation means heart beats harder or faster.
2. Unusual sweating
3. Trembling or Shaking
4. Shortness of breath (Swallow breathing)
5. Cold or sweaty limbs
6. Not being able to be still and calm.
7. Dry mouth

If any of the above-said symptoms exist in the clinical environment, then suspects white coat hypertension.

How do know you have white coat syndrome?

You may be nervous or anxious about your blood pressure taken by the doctor or nurse without you or your doctor realizing it. The only way to know for sure is to compare the readings taken in the doctor’s office with readings taken at home. 

If your doctor suspects white coat hypertension, then he/she may ask to check your blood pressure at home or to wear a device called an ambulatory blood pressure monitor. Usually, worn this device for 24 hours and can take blood pressure every 30 minutes.

What can you do about white coat hypertension?

You should wait for 3 to 5 minutes before measuring your blood pressure. The best practice is to take 3 BP measurements and average the readings to get your exact blood pressure measurement.

Relax and calm down helps to bring your blood pressure back to normal. Just rest for a while before having your blood pressure measured. Take few deep breath, ensuring the diaphragm (not the chest) inflates.

Studies have been suggested that white coat hypertension may simply be a precursor of sustained hypertension.

Reference: Isolated office hypertension: a prehypertensive state? Journal of Hypertension. 1996; 14:327–332. People with white coat hypertension do not need any treatment. Still, they are more prone to hypertension later in their lives.

Thus people with white coat syndrome need to follow high blood pressure lifestyle changes to prevent or avoid hypertension.