Aa
A
A
A
Close
Heart Disease Community
20.2k Members
Avatar universal

Chasing A Rainbow

I am 66 years old, 5ft, 3", medium build, weight 143 lbs, 31.5 inch waist.  I ride a touring road bicycle 5 days a week, 20 miles, 100 minutes each ride.  I also lift free-weights and dance.

I have had hypertension for 30 years and white coat syndrome for the past 10 years.  During the past ten years I have taken my pressure and pulse at home using a digital machine.  The accuracy of this machine has been verified by three doctors.

My medication has effectively done the job controlling the hypertension.  However, during the past ten years when I am in a medical environment regardless of the type or situation my pressure is elevated.  During the past ten years multiple doctors have all acknowledged my white coat syndrome and based treatment on my readings outside of medical environment.  

Recently, I relocated to south Florida and have yet another primary care doctor.  This doctor, however, refuses to acknowledge white coat syndrome and insists readings should be at the same level regardless of where and when they are taken.

Since my first physical with this doctor he has had me come into the office every month for the past four months.  Each visit is a mirror image of the previous visit including listening to my heart and lungs.  The nurse takes my pressure, pulse and weight.  Typically, the pressure is 160/75.  He sits in his chair looking at my medical record, makes notes and says very little.

His most recent decision was to have me take my pressure and pulse at home every day at various times for a month.  I took pressure and pulse readings 88 times during the month.  The overall averages were pressure: 109/59 and pulse: 43.  My activities immediately preceding the readings represent 95% of my typical retired life style.  After very briefly looking at the report I gave him he instructed me to change my medication from Atenolol, 50mg daily & Lotrel, 10/20mg daily to Atenolol, 50mg daily & Lotrel, 10/40mg daily.  He also scheduled me for yet another follow-up visit in three weeks.

Here is what I think:

1.  Do not change my medication.  Continue to focus treatment on the majority and not the exception (white coat syndrome) which would typically occur a couple times a year.

2.  Stop these redundant office visits and return to a schedule of an annual physical and one or two follow-up office visits per year.

3.  Continue to monitor my pressure and pulse on a regular schedule at home.

What do you think?

Thanks
Purusha
  
2 Responses
Avatar universal
or you have another choice.  Switch doctors.  They are plentiful in S FL.  
424634 tn?1277857528
I agree with FLBrat...  I'm fairly new to this cardio stuff, but from what I have experienced, the docs don't really listen, or consider that we know our own bodies.  I too have white coat syndrome (180/90) when I go to the doc.  I told him it was below 120/80 outside of the office.  He had previously given me BP meds, and then told me I didn't have to take them if I was sure it wasn't high outside the office.  I'll be seeing an opthalmologist this week... the cardio dude said to me "the opthalmologist will tell him if I've got high BP".  He still doesn't really trust me.  If I were you, I'd find another PCP.
Have an Answer?
Top Heart Disease Answerers
159619 tn?1538180937
Salt Lake City, UT
11548417 tn?1506080564
Netherlands
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.