(Lubbock Avalanche-Journal) Dear Dr. Donohue: My husband has “white-coat” hypertension in the form of highly elevated blood pressure whenever he goes to the doctor for his routine checkups. He has a blood pressure monitor at home and checks his blood pressure at least once daily. The machine was calibrated twice by the doctor and was found to be accurate. His readings at home are always 120 or less systolic over 80 or less diastolic with the home machine, but can be 160 systolic at the doctor’s office. Does he need additional medication for his blood pressure?
Reactive hypertension — high blood pressure resulting from a situational rather than a medical source — is very common. When it’s the result of seeing the doctor (the “white coat” part), it can lead to overtreatment if not recognized. You and your husband have done exactly the right thing — bought and tested a home machine, and your husband regularly tests his blood pressure at home.
If the readings at home are consistently good and there are no other signs of poorly controlled blood pressure (the doctor may look at the back of the eyes, listen to the heart, check kidney tests or even get an echocardiogram to look for signs of damage from high blood pressure), then I would not recommend additional medication.
For others in the market for a home machine, home blood pressure cuffs that go around the upper arm, not the wrist or a finger, tend to be the most accurate. Definitely bring it in to the doctor so that it can be checked for accuracy. More blood pressure measurements mean better information for you and your doctor to decide about treatment.
Read More Medical Q and A from Dr. Paul Donohue >>
(11 votes, average: 4.36 out of 5)
Loading ...
Loading ...
I had (have) the exact same problem. My home monitor, calibrated by the doc’s machine and verified by an occasional stop at a paharmacy’s free bp check machine, revealed that my high bp at the doc’s office during checkups was “white coat” related. As a result, we cut the dose of lisinoprel down to once a day and my bp continues to be low at home, sometimes reaching the 110/61 level. When it goes low, my pulse seems to increase. I guess this is the body’s way of compensating.
Thinking that “no difference” between ’11 and ’12 thalium stress test meant continued stability, I was surprised by A Fib while being prepped for cataract procedure. The following 90-minute monitoring in ER just resulted in prescription of Bystolic, without any information whatsoever about the significance of A Fib, and whether my cardiac health is now more precarious, calling for closer monitoring. My cardiologist’s nurse remains the sole professional responding to inquiries, and makes it appear that I am well served with the same type of semi-annual check-ups I had before the incidence of A Fib. Should I just relax about being given no more scrutiny since the AFib? I am uncomfortable about accuracy of self-monitoring.
I have what I refer to as “Hybrid Hypertension” It’s a little bit of mild hypertension with a lot of White coat thrown in the mix. It gives me a very elevated reading in the Dr. office. I just bring in my log to show the doc my home readings. He hasn’t increased my dose of 10mg Lisinopril as it keeps me at 115/65, however I still spike in the Dr. office even with the meds.