The doctor's office sent me to the ER when I had 210/160 . All my tests too came out negative. The ER put me on beta blockers which I took religiously until I saw a Cardiologist. At my appointment with the Cardiologist I was so worked up that my BP despite the beta blockers shut up to 255/130, again I was rushed to the ER in a wheelchair, his office was right by the hospital.
My BP at home was 115/75 - 120/80, but I was still put on BP meds because the Cardiologist, and the Hypertension Specialist I saw said how do they and I know what my BP is driving in traffick, when I get scared about something etc. They both told me they put their patients on BP meds once the BP goes way over 200 at the doctor's office.
But the Hypertension Specialist also told me that under extreme anxiety or in some people extreme anger your BP will still shoot up despite the meds, but not as extreme.
The Cardiologist told me to take my BP at home and bring it with me to my doctors appointments and not have my BP taken at the doctors office anymore until I get help to overcome this severe white coat hypertension.. Believe me I tried for several yrs but to no avail because the Therapists DON'T understand it. They think they do but they don't and I switched to different ones.
I now take my BP at home bring in the list to my doctor, no more anxiety, and my doctor is pleased with the readings I bring in.
My nephew has the same problem...at home its fine,, but as soon as he gets in the dr. office it goes off the chart...the dr. said that he needs to have a drive up window for people like him..so he doesn't get so stressed... the dr. called it white coat syndrom.
hope this helps...good luck