973741 tn?1342342773

Is white coat syndrome real in hypertension?

I've read about it but am wondering what others think.  Is white coat syndrome a real thing?  Does going to the doctor and having your bp taken really elevate your bp?  
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Avatar universal
Yeah, it's real.  It's odd to me because getting bp tested is so easy but I guess it's measuring the high stress so many get when they go to the doctor.  It's a very common phobia.  I wonder what it is when going to the dentist?  It's not at all related to a chronic BP problem, and even with most people chronic high BP if not off the charts can be treated with changes in exercise, diet, and lifestyle.  But of course some don't respond to that and for them meds are necessary.  As with all meds and all docs, what we call allopathic medicine has a very quick trigger finger with medication, as that's what's taught in medical school by pharmaceutical company paid teachers and textbook writers.  So many doctors are paid in some way by the pharmaceutical industry when the FDA tried to ban anyone who did take money from pharma from review boards, they couldn't fill them as all the most respected "experts" were on the pharma dole in some way.  That's why drugs are so much more expensive in the US than any other country, as prices for drugs are regulated everywhere else.  Be careful out there, always listen to your doc but as they say, trust but verify.
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Avatar universal
It's very real.

My resting heart rate is 72-78 beats per minute.
Last Dr's office visit when they checked the blood pressure it was elevated and my heart rate was 102 BPM.
At home my heart rate only increases slightly when checking blood pressure and the Blood pressure is much lower.
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I tried really hard to believe I had white coat syndrom.  Truth is, I was borderline. I think that white coat syndrome can happen to some extent but it is a bit overstated.  If the readings are of a certain level consistently in the doctor's office, there is a chance you are hypertensive.  It's smart to check your bp at home.  I"m glad your bp is within normal there.  But if you keep seeing blips of increase, talk to your doctor.  I kind of regret not doing something sooner.  Elevated bp for a long time can do damage to so many parts of our body.  Boo. I'm hoping I didn't do that.  I started bp medication a little over a week ago.  
https://www.pennmedicine.org/news/news-releases/2019/june/people-untreated-white-coat-hypertension-twice-likely-die-heart-disease  People with 'white coat syndrome' TWICE as likely to die from heart disease.  And https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486636   A precurser to hypertension.  I would talk to your doctor about white coat syndrome.  It's in your best interest.  
This was one badly done study, Mom.  It's not a thing most likely.  Chronically high BP is a problem.  One time not a problem.  Everyone's had high BP at times, if that's a problem we're all doomed anyway and medication for BP isn't benign.  Best to not worry, that's the best thing for preventing BP.  Now, you apparently have a genetic predisposition, which doesn't mean you'll get it, just that you have a higher probability.  Also doesn't mean you can't fix it by changing some things, but it might.  But if a person only gets it during a doc's visit, hard to see how that can possibly translate to a chronic condition.  
Just to more fully explain, this study is a meta study, not a clinical study.  They reviewed a bunch of small studies, most of which proved nothing as most studies do prove nothing, and found these results, but it should be noted, almost everyone dies from heart disease so it's hard to see how any group is twice as likely to do so.  My Dad got pneumonia and emphysema from smoking, but he died from heart disease.  He died of a heart attack.  Did smoking kill him?  Yeah.  But is that how we measure death?  No, we measure by the heart stopping beating.  That makes it very difficult to tell what really was the long-term cause of death vs. the immediate cause, which is almost always getting to where the heart stops beating.  My wife's Mom died early this year in her 80s when she went to sleep and never woke up.  She did have a heart problem, but survived that.  She died of heart disease, because the reason she never woke up is her heart stopped beating.  We all want to go that way, while sleeping.  It's how my dog died.  But in both cases, they really died of term limits, meaning that's the length of time their bodies were born to survive for and they died of having lived, to paraphrase Willa Cather.  In the records it goes down as death from heart disease, though.  And the recommendation of the authors of the study is to follow people with a monitor for 24 hours, which I think is probably not enough time, but it's basically saying it's not a diagnosis made by the office visit but by following the person to see if they actually have chronic hypertension, not just during the office visit.  Meaning, docs assume it's just at the office and maybe it's not.  That would make it unrelated to white coat syndrome and make it attributable to chronic high BP.  Peace, all.  
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