Do You Have White Coat Syndrome?
July 29th, 2008 by admin
You have probably experienced this before, going to the doctor and they go to get the cuff to take your blood pressure and you feel your heart pounding. This is white coat syndrome or blood pressure that rises in response to the anxiety of visiting the doctor. The problem with this syndrome is that reading may be seen as your normal reading. You may find that using a device that measures your blood pressure for 24 hours throughout the day to give an accurate reading. Or you can take multiple readings and take note of them to bring them to your doctor.
Need Practical Help?
how do I learn to control white coat syndrome? just the thought of having my blood pressure taken makes it rise dramaticallyi. I am afraid to go to the dr. because they want to put me on medicine and I won’t take it.It really is a serious problem with me.I monitor it at home but some drs. still want to go by their readings.I need an alternative to get over this problem. after the loss of my brother and mother i suffered severe anxiety and started taking st. johns wort and it helped the anxiety and blood pressure.But if a person approaches me for my blood pressure it goes up and what is funny I can usually feel it going up and can tell you what it is.It feels like a surge in my chest.
Hi Carol,
Good question. There are actually a couple of things you can do.
First, do keep good records of your ‘at home’ monitoring so you can bring it in to the doctor and show him what your normal readings are. You might also want to bring your blood pressure monitor in to the doctor as well so he can use it to verify that your monitor is accurate. That should help relieve some of his anxiety.
Second, taking your blood pressure at home regularly is a great thing to do. It does help lower your blood pressure and it also helps desensitize you to having your blood pressure taken. Beyond this, you can begin to imagine that your doctor is taking your blood
pressure which begins to desensitize you to the doctor’s presence. You can also practice by having family and friend’s take your blood pressure until you are comfortable having somebody else take your blood pressure.
Third, practicing a method of slow, deep, regular abdominal breathing helps to lower and stabalize your blood pressure. You can employ this method for the 20 minutes or so that you have before you see the doctor and while you are waiting. Learning how to do this technique well at home before you see the doctor will give you some immediate control when you see the doctor. You can learn more about this technique here:
http://www.lifematters.com/resperate.asp
Thanks for asking,
John
I am somewhat confused about a situation that I recently experienced concerning a high blood pressure reading while in a stressful medical situation, and while this comment helped me somewhat and I was wondering if you could further help me. What are some of your blood pressure readings in the doctor’s office? I have had repeated normal blood pressure readings up until about a year ago, although recently during a medical emergency I had a reading of 140/110. The EMTs did not seem concerned by this, and did not urge me to go to the hospital for my orginal emergency nor my blood pressure. Is it possible that this is also part of a white coat syndrome or the possibility that my pressure was elevated this much due to stress? Than you for any help that you can give to me, I truly appreciate it and look forward to hearing from you.
Hi Amanda,
It is entirely possible that this elevated blood pressure was due both to stress and the white coat syndrome. The 140 part is not really a problem, particularly if it occurred just once and the top number goes up with stress quite easily. The part that is concerning here is the 110. The bottom number doesn’t usually go up with stress so I would recommend starting to monitor your blood pressure regularly on your own to see how it is running. That way you can tell if this is an anomaly or if you are moving toward a higher blood pressure.
I monitor my BP at home myself and it is always low.(average 135/75)and my internist thinks its good and sees no further need to change my medication. The problem is I have been trying to have some elective face lift surgery and the surgeon will not do it if is elevated when I go to have it done and it’s always high when I’m in his office (151/91 +/-). He says he accepts my internists view that it is okay, and said he will schedule it again, but if it is elevated when I go in to have it done, he will not do it. I know I don’t have a BP problem. What can I do???
Hi Mike,
The good news is your blood pressure is normally good. Since it spikes when you are in the plastic surgeon’s office that means you are vulnerable to elevations of blood pressure due to stress. There are a couple of ways to deal with this. One is to learn a technique such as slow deep abdominal respiration that has been shown to lower your blood pressure, it is very effective for stress induced blood pressure changes. Once you learn how to breathe abdominally you can then desensitize yourself to the doctors office by first imagining that you are in the doctor’s office while taking your blood pressure and then apply the breathing technique to lower it. You can even go so far as to take your blood pressure yourself in your doctors office waiting room to practice lowering it in that location. This is called ‘situational desensitization’ and can be very effective.
Thanks, what’s the trick to breathing abdominally?
When i go to hospital or clinic,and take a blood pressure,i had a a reading of 140/100,and again i relax its always 140/100,but in the house its 120/80 sometimes 110/70.I am only 26yrs. of age.and thin person.And the nurse and doctor wondering my blood pressure.They put me in the ECG but its normal.What should I do when i go back again for medication?This is my 3 times visiting a clinic or hospital i always got a blood pressure of 140/100.This my always problem i cannot manage my White coat syndrome.I avoid Drinks with caffeine and i exercise daily,and drink to much water.And third time visiting clinic,140/100 again.What is best thing to do to lower my blood pressure visitig again?What can i do???????
The trick is to use the diaphragm and not the chest muscles. This may feel strange at first but with practice it becomes quite natural.
The best thing to do is to learn a relaxation technique. The mild stress of having your blood pressure taken by the doctor raises your blood pressure. You can change this by counter-acting the stress response with the relaxation response. The relaxation response can be activated with abdominal breathing. You can use the Resperate to help train you. I have used this exact method to help me with the exact same problem so I know it works.
I’m a young woman who has always had a great fear of doctors and doctors’ offices. This is mostly because of my crippling fear of hypodermic needles. I see one, and suddenly, I’m in defense mode. The moment I know I’m going to get a shot or even go into the office where I might have to get a shot, I am set on edge. Once when I was a young girl, I actually attacked the nurse who tried to give me the shot and I broke the syringe. My parents have told me that even when I was a little baby, I would scream and cry and kick at the doctor’s office. Normally my blood pressure is 120/60, but when I go to the doctor and they take it, it skyrockets to 180/120. I have never been able to think of going to a doctor’s office without feeling my heart pound, but I have difficulty telling if it’s just my fear of needles, or if I also have a fear of doctors. Even when I know I won’t be getting any shots or have to face any needles, I still get so afraid that I end up hyperventilating in the office and freaking out in the private room. Is this white coat syndrome or do I just have a crippling fear of needles, or is it both?
Hi Delia,
It sounds like you have both. Probably the white coat syndrome is the result of your fear of needles and doctors. Depending upon the doctor you can often take your own blood pressure at home over time and keep a record yourself. That way they see a history of normal blood pressure and they can see that you don’t have hypertension.