Posts made in March, 2014

White Coat Syndrome or White Coat Hypertension

Posted by on Mar 17, 2014 in News | 0 comments

White Coat articleYou may have heard of the term white coat syndrome in the doctor’s office. If refers to the condition where patients have elevated blood pressure (greater or equal to 140/90 mmHg) in the clinic setting and their out of office blood pressure readings are less than 140/90 mmHg. It is called white coat hypertension because the anxiety and nervousness are thought to come from seeing healthcare professionals with white coats.

These patients may or may not have high blood pressure. However, it happens to a lot of people with known high blood pressure. The doctor will ask whether you are taking your medicines every day. If you are taking them regularly, the doctor will ask you to record your blood pressure at home both during the day and night time. It is important to monitor your blood pressure at home daily for at least 2-3 weeks.

Another way to find out is that the doctor will give you a small portable monitor to wear for about 24 hours. The device will measure your blood pressure every 15 to 20 minutes during the day and every 30 to 60 minutes during sleep. The device will then calculate your average day time blood pressure and average night time blood pressure using the recorded data. Both methods will help doctors determine whether you are truly hypertensive or your high blood pressure in the office is due to white coat syndrome. For hypertensive patients, it is helpful to see if your current treatments are working or not.

If your blood pressure is less than 120/80 mmHg, it is considered normal. If your blood pressure falls between 120/80 mmHg and 139/89 mmHg, you have pre-hypertension. If your blood pressure is 140/90 mmHg or greater, you have hypertension or high blood pressure. For 24 hour monitoring device, normal 24 hour average blood pressure is less than 130/80 mmHg. Your day time blood pressure has to be less than 135/85 mmHg to be normal. Night time blood pressure has to be less than 120/70 mmHg to be normal.

Patients with white coat syndrome are at risk for developing high blood pressure in the future. Studies showed that people with white coat syndrome have slightly higher risk for heart diseases and stroke compared to people with normal blood pressure.

If you have white coat syndrome or hypertension, you should make a few changes in your lifestyle. These include:
• Cut down salt (sodium) in your meals
• Maintain a healthy body weight
• Keep yourself physically active
• Quit smoking if you smoke
• Avoid alcoholic drinks
• Get a home blood pressure monitor and check your blood pressure at times
• Reduce stress at home and work by learning relaxation techniques and meditation
• Avoid smoking, caffeinated drinks and exercise before going to your doctor’s appointment for blood pressure check-up since they can alter your blood pressure reading

Contributed by Patricia Hsiao M.D.
Sources: uptodate.com, nejm.org, mayoclinic.com, nhlbi.nih.gov.org

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