Q: My problem is that I am terrified of doctors and my blood pressure goes extremely high around them and then then start shouting and threatening me with the stroke and heart attack warnings which makes it go even higher. At home my BP is normal. How do I control my fear?
A: You aren’t alone. What you are describing is known as White Coat Syndrome or White Coat hypertension. You might want to take a friend or spouse with you on your next appointment. Having a familiar person with you during a visit can help relieve anxiety and help you remember advice given by the doctor. Focus on something else when your blood pressure is being taken. One of the reasons I like the Resperate is that it trains your mind to associate music with relaxed breathing. You can use your memory of the Resperate music to slow your breathing and relax in stressful situations. Keep in mind that recent studies suggest that White Coat hypertension is a risk factor for developing high blood pressure later in life. It is important for you to have your blood pressure checked regularly.
“Keep in mind that recent studies suggest that White Coat hypertension is a risk factor for developing high blood pressure later in life.”
Since blood pressure increases with age, getting older is also a factor in developing high blood pressure later in life.
Other factors include air, water, and of course, life. I wonder who funds these “studies”? LOL!
I always wondered why in certain countries, blood pressure almost never rises with age. Those countries have cleaner air and are isolated. Also, those countries use plant-based folkloric herbal and nutrition-based treatments for almost anything, and doctors are few. Example, certain African countries, and in Europe, the isolated Caucasus. Any reason why? Is it the food, air, water, herbs? Or genetics? Because those in Africa don’t get high blood pressure as a whole, but Africans in the USA do. Same goes for Pacific Islanders, Asians, Native Americans in Peru compared to those in the US. Is it the high sugar diets here? The need for low-carb diets? Anyone know?
I believe the single most important factor here is diet. In those countries you mentioned, they have a lower carb diet than here in the US. I eliminated ALL grains and “bad” carbs from my diet. Also got rid of sugar. My bp was at 106/78 with a resting pulse of 74 this morning in the cardiologist’s office, white coat syndrome and all! I believe many people could get off their meds and never develop high BP with a diet like this. I am occasionally allowing a bit of bread and a glass of wine and still, my BP has been consistently lower than 120/80. It was in the 140s/90s just two months ago! Consistency is key and of course exercise and plenty of sleep. Cut out the coffee if you can. If you do all three you will see results for sure. Resparate is good too because it lowers atress and habituates your system to the proper breathing for optimum heart efficiency. Meditation is great too and does almost the same. But Resparate is part of the mix for me.
I know you are right. The american diet is terrible and although we never eat junk food or eat out, preferring our own cooking, it’s hard to do with all of the commercials, & cooking programs on TV.
I know this is an older post, but for me it’s got to be a combo of anxiety, sugars and genetics. We eat largely a mediterranean diet in our home and exercise every single day. I have white coat hypertension. Normal/low at home. I cannot control it at the dr’s office. It is always 14/80-160/90 at any doctor. So, if I develop true HBP, I know it’s largely anxiety, and part genetics, environmental factors, and the added sugar I try to hard to avoid, but inevitably consume too much of when I eat “healthy” treats like Kashi Bars. So frustrating!!! I was so happy to read that the studies showed that home monitoring was more reliable than the office. According to that, my BP is optimal. But, which reading counts???
You got it! Good for you in pointing out some truth!
This is white coat terrorism and needs to be ileminated from med school. My blood preassure is always 240/180 and I have all the histeronics and I out live all these bastards. I am health, normal, and 70. I plan to live along time with the problem my whole family has. Take a breath and find a doctor worth his walletdectomy that can deal and you will do better also.
I believe that I mentioned this before on another question, but if it might help someone, here it is again. This is based on my own experience of having a terrible case of white-coat hypertension. Here is my solution. I take my blood pressure at home on a regular basis. I use a machine that stores my blood pressure readings over 30 readings, which can cover a month of monitoring, or more, depending on how often you take your blood pressure. I take my own blood pressure monitor with me to the doctor’s office. Knowing that I have the proof of normal blood pressure with me, helps with the doctor-induced hypertension. And, the best part is, that I can show my doctor my blood pressure readings over the last month. The last time a I did this, the doctor did not deliver the theatrics even when my blood pressure was high in his office. I think it helped him realize that he was part of the cause! Maybe in time, I can have a normal blood pressure taken in a doctor’s office, but for now, my recorded readings stored in my own blood pressure monitor are my reprieve! All the best!
I have done the same thing, using a home monitor with memory of 99 readings. Its never high at home ( 110/68) but frequently high in the doctors’s office. I was told BP should not go high but stay in the normal range even if you are nervous/scared. But now I see I am not the only one with this problem. Having the doctor threaten with stroke and saying you ” probably” have kideny damage, etc. is very stressing, I have had that happen too and then all tests from cardiologist were normal.
I hear you it always happens to me just what you describe in in your comments, only the doctor did not want to see my reading in the monitor I took to show him my readings that were not the extreme high in his office but he showed the theatrics ,seems like he did not believe in the white coat-hypertension did not like his attitude seems like there was no help on his part being a doc he needs to show better solution
I tossed my home monitor in the thrash.
Reason being: One can become obsessed with taking blood pressure. I felt it added to anxiety. Blood pressure rises and falls throughout the day and even if taken at the same time each day it may be different, depending on what you are doing. I decided to trust my (new) doctor and, although my BP is not perfect it has been below 140/90 at the last visit. And, she does not take my BP every time I visit her, which also reduced my anxiety and probably my blood pressure. I am overall fit and healthy, my blood chemistry is good, and I think she takes all this into account.
I too have the White Coat high blood pressure. I’m 80 and have had really high BP at times when being tested in hospitals or Dr. offices where the automatic bumps are used. They pump up and then pump up some more until my arm will have broken blood vessels. It’s so painful and I have asked them to please do it manually. It’s usually much lower and not as painful. Am I the only one that has this problem with the machines?MY BP meds are not doing the job and my PCP keeps changing them to no avail except they keep getting more expensive. My latest readings are in the 190/90 range. 140/80 is my normal-still too high!
I will no longer take BP in doc’s office. I monitor mine at home and take in my numbers when I see her. Each and every time I get BP taken in office, it goes sky high. White Coat…oh yes.
I am older, 72, and keep mine at 130s/70’s in that area. It varies moment by moment. Foods, thoughts, etc.
Joyce,
Is it possible to have a doctor’s app’t without bp beng taken? I’m n such a panic now that I never want to see a doctor again. Not a good idea since I’m almost 60. But for the first time in my life I feel like I’m being treated with contempt–never any reason for that!
Joyce,
I too have white coat hypertension that has left me having anxiety attacks every time I have to see a Dr. The Dr. I am currently working with knows this is an issue and doesn’t make me take it in her office. She wants me to take it at home. Dr.’s make this way worse than it needs to be and are causing much of the problem!
and yes doc gets panicky and screams stroke, etc. No more of this in her office.
Also, be sure of potassium and magnesium levels. Gotta keeps those levels up.
Hello,I do the same thing as the person above does,but my doctor wants to see only a weeks worth.I do check bld pressure when I am out and about at places that have a bld pressure machine as well.I have been trying to lose weight and tried going to the doctors for a check first thing in the morning rather then the afternoon.The first time in a long time my bld pressure was actually acceptable to the doctor.I have tried many things but I do have a bad case of white coat syndrome.I don’t know what else one can do.
A few years ago I was having much lower readings at home, and finally brought my blood pressure machine with me to be checked at the Dr’s office. Lo and behold, the readings were way off. I immediately replaced the instrument, and my readings were indeed high.
Yes, I think many home-monitors are actually off. That is another reason I tossed mine in the thrash, although, when I checked it once against the doctors BP reading, my monitor was 20mm higher and put me in the treatment range. The doctor’s reading was below 140/90. She told me not to use it anymore.
I have been accused of having white coat syndrome myself even though I am perfectly at ease in the Doctors office. Prior to my appointment, I have taken my blood pressure which showed normal. I firmly believe after readings are taken on literally thousands of patients it is entirely possible that the analog BP wall units may be grossly out calibration. Doctors should switch to digital BP machines which are considerably more accurate than analog readings.
My blood pressure is always high when checked in the Doctor’s office. I drive through traffic, find a place to park, walk in, register and they call me in RIGHT AWAY to have my vitals taken. YES, it will be high, besides the white coat and I really don’t like those automatic cuffs that get so tight. I also can’t stand anything tight on me. I use to have a cardio doctor when we lived in another state that let you relax before taking your BP and used the old fashion type which was never a problem. So from now on I plan on getting to the Doctor’s office 1/2 hr before my appointment and not having a seat for about 20 minutes before I register in and hopefully that will make the difference, because my BP at home is always within the normal range.
It’s getting harder and harder to find a GP who’ll think outside of the hypertension industry and defensive medecine. But keep trying.
To all, I suggest following the Mayo Clinic’s definition of high bp, including that a spike in bp needs to be sustained (for more than 15 minutes immediately following stroke lecturing!) Some GPs don’t like any spikes over 140/90. But it’s up to an empowered patient to use own judgment based on most reliable sources available. Be well, all.
I agree with all of you, When I go to the Doctor, My BP goes as high as 175-90 and at home it ranges in the 112/80 sometimes 122/85 range. I was keeping a record for Months before I saw her this time. She knows that I have Whitcoat syndrome, and when I asked her about BP Meds she said no because I can see it’s high when you come here. I am already taking Beta Block Low Dosage 10MG. Propranolo 1 in Morning and 1 at night. I have always been this way for years no matter what Doctor I see. Although I agree, it’s high it does not stay that way. It goes down after I leave the office.
One thing not mentioned on the replies is that your blood pessure should be taken at least three times… the first numbers are discarded (white coat synd.) and the second and third one averaged.. But how many of you have a Dr. (or the nurse) take it more than once, even tho you tell them you have wcs???? I have finally found a Dr. will take it two more times after we have quietly talked for a few minutes. I refulse to take medication.. it may lengthen my life a few months, but life is too short.. When I did I was a walking zombie, and hurt so bad. Instead I started eating healthy, vegies and fruit, very seldom beef, etc… and my BP dropped to avg of 130/70….
I agree with you. I always tell them I have wch and they try and talk me into letting them take it. Usually I refuse (I take it at home) but my new holistic Dr acted like he knew what he was doing. Took my bp while I was sitting on an exam table, legs dangling and he held my arm up. Then he acted like I was going to die any minute because my systolic was high!
My nurse insisted in my holding my arm out completely straight while she supported it with her hand, although I have read that keeping it bent horizontally at heart level will lower the reading by about 10 points s&d. Why don’t nurses know about Mayo Clinic recommendations–like averaging the second and third reading? Anybody able to confirm this arm position concept?
Whenever I go to the doctor’s office, they do not ever follow the standard procedures they are supposed to for taking an accurate blood pressure reading (arm resting at about heart level; feet on the floor; no talking). You rush to get there, are nervous, sit on the table and then they immediately take your BP (incorrectly!) Is it any wonder that it is high?!
I do not think there is any solution to the white coat syndrome. It’s just a surge of adrenaline that comes in the “heat of the moment” Doctors offices never produce a relaxed state of mind for me. I can’t agree more with D. Carestia’s comment on keeping the log for 30 days which will dispel any preconceived notions the docs may have about the “severity” of your hypertension. It turns out I did have a bit of real hypertension in addtion to a whole lot of white coat syndrome which markedly skewed the numbers. I was given some medication to bring my real hypertension down to normal but it still spiked in the docs office. So, these drugs will not stop the white coat surge.
I can’t agree more with keeping the log at home to bring in to the docs office as proof. I learned the hard way last year in that I did not check my BP at home and got a high reading at my exam. I was given a prescription med. Later after checking at home I realized I had the white coat syndrome. Bottom line, don’t let the docs OVERMEDICATE you and TREAT YOUR WHITE COAT SYNDROME!! You spend 99% of the time outside the doctor office.