White Coat Syndrome

[Bushkey]

Good morning, and thank you for taking time to answer my question.  I am presently on Lopressor 50 2x daily and Diovan 80mg. 1x daily.  My pressure is perfect at home, and when I take it at work (ranges are 120/70 to 115/60's). I consistently monitor it with 2 different machines. When I go to the Dr. it's high... this is very frustrating.  I actually feel myself having anxiety when I enter his office. Is there anything I can do to help myself when I enter a Dr's office... Have you heard of other people with this problem... Thank so much.  I really appreciate your time and patience.

[worryer]

Hi,

I'm an 18 year old with White Coat Syndrome. It was first doscovered at the doctor's with a blood pressure at 180/70. So I saw a Cardiologist and things got worse and as I got more panicky the more my blood pressure rose. I went for umpteen tests and finally they've come to the conclusion that I suffer from suspected "Severe White Coat Syndrome". They finally put a 24-hour monitor on (a total nightmere) and it came down to 140/60. My normal reading should be about 125/60. However, I am badly overweight so it was good enough for the cardiologist. I am currently still on Accupril (15mg) just for good measure. (My blood pressure is still a little over the norm). The other problem with me is that I'm a constant stressed out worryer. I can never relax, and I start fidgeting when I sit down. I also have a tendency to feel my heart beat. The only thing that relieves this is exercise. By the way - I'm around 110 kilogrammes at 6ft 0".

[Bushkey]

Hi, went to the Dr. with my BP machine.... had the same reading as him....180/90 -  my pressure was running 98/62 to 120/70 at home.  He said I definitly have white coat....  stayed in the office for about 1 1/2 hours and it went down to 130/78.... What a piece of mind that was... tell dad not to worry!!!

[ablee15]

Bushkey;
    I am so glad to hear someone else has this same problem, my normal BP is 110/80 at home even when I am out and I have it checked it is fine, and everytime I go to the doctors office it is 140/90, or even 160/110, I go home and take it and it is normal, we finally figured it was white coat syndrome. One doctor wants to put me medicine for hypertension. it is so strange.

[Stan H]

I have the same situation which, actually, is quite common.  My readings in the doctor's office have been as high as 160/90, but are typically 130/80 or less at home.  A 24 hour bp monitor gave me an average of 125/75 during a full work day, and 118/72 during the night.  I am on 50mg of Cozaar daily to help regulate my bp, but it is still always high during an office visit.  The 24 hour monitor that has been suggested by the doctor here is something you might want to check out.

[alexawesome1]

Dear Bushkey, A while back (3 years) I experienced a few skipped heart beats.  This got me really anxious overall. My initial visits to doctors regarding this would also result in blood pressures of 160/90 to 170/90, but when checked otherwise was normal at 135/80 to 130/80.  I found after investing this matter by 2 cardiologists I found that it was ANXIETY being build up for many years (I'm now 27).  ANXIETY is an awful thing.  It will make your blood pressure increase and heart rate increase, cause headaches any many other phyical reactions.  It's really a state-of-mind.  In my case, seeing the doctor would naturally want me to make my own results perfect, like satisfying the medical "norm" in all physical respects.  Aside from actual physiological issues, ANXIETY will definitly increase your BP.  I found comfort in taking my mind of the fact. It's hard to pretend your not in a doctors office but you'll have to pretend that the office is Paradise and the White Coat is Cindy Crawford/Brad Pitt (depending on your taste) in disguise. It's not a pratical scenario but one that works!  I found some good sources of relieving the anxiety, such as exercise, water activities, good diet and etc. If you enjoy reading then: Natural Healing for Anxiety and Depression" Harold H., M.D. and Healing Anxiety Naturally" Harold H. Bloomfield at Amazon.com There are also many other web sites and forums for such discussions. Hope this has helped in any way... feel free to email: alex_dolgonos***@****

[Freeze]

I have White Coat Syndrome and have a question that may be a little off subject but it is very difficult to get any information on WCS. In addition to my blood pressure going through the roof when I go to the doctor, I have noticed that my glucose levels, while still normal, are elevated about 10 points compared to screening tests in a less stressful envoronment. I am trying to reason whether this is also an effect of WCS. I've heard WCS described as the "flight or fight" mode the body goes into with the result of released adrenelin.  I understand that the adrendelin causes the liver to release sugar into the bloodstream while the body sort of shuts out the absorbtion of the sugar by muscles in order to send more to the brain. Would this explain the elevated glucose levels?

[Kek]

This is great!  Not that your blood pressure goes up in the Drs. office, mind you, but that there is actually a name for this situation!  This has been happening to my dad for years.  The Dr wanted to put him on meds, but he refused.  He can be a bit anti-medication at times.  His reasoning was that every time he took it at the pharmacy, it was normal or even a bit low.  My mom said he alsways gets "worked up" when he goes to the Dr.  I can't wait to tell them what's "wrong" with him (smile)

Thanks all!

[CCF-M.D.-CRC]

Dear Bushkey,
"White coat syndrome" is a description of the finding of elevated blood pressure during a stressful situation (such as a doctor's visit) and normal blood pressure at other times.  There are 2 schools of thought on this issue.  The old school thinking was that the blood pressure was controlled most of the time and therefore the elevated readings at the doctor's office were not of concern.  The new school thinking is that elevated blood pressures at the doctors office mean that the blood pressure is still elevated during stress (which everyone has daily)  and increased medication is needed.  One other thing that you need to do is calibrate your blood pressure machines against the doctor's office.  It is possible that your machines are reading low.  Finally you may ask your doctor about getting a 24 hour ambulatory blood pressure monitor test.  You may be surprised at the results.