White coat hypertension
White Coat Hypertension (also called White Coat Syndrome) is an interesting and perplexing condition - it is as if your body is playing pranks on you, like a naughty kid. You go to the doctors and after repeating the checks a few times, you are diagnosed hypertensive. Yet every time, when you get home after the checks, your pressure has gone back to normal again. It is normal because it was not measured at the doctor's! I wonder how many people were (or still are) on unnecessary treatment because of this. Studies suggest that up to a third of people may suffer from this form of hypertension.
The diagnosis is of course made by getting blood pressure measurements done at home - and preferably not by the doctor! Home monitoring, including the use of what is called Ambulatory Blood Pressure Monitoring (ABPM), is the only way to do it. ABPM involves regular measurements throughout the day, giving a good picture of blood pressure and its response to various situations over 24 hours.
Single readings using a home monitor have been found to provide results that are as reliable. (You can read more about home monitors by clicking here.)
The condition is not fully understood. It was thought to be due to anxiety associated with being in the clinic environment. (I could understand that happening at the dentists, but in most cases the doctors office is hardly a threatening environment). In any case, too many people exhibit this phenomenon who are clearly not stressed by the situation, so clearly some additional factors are at play here.
Apart from not being sure why it happens, doctors and researchers have not been sure as to its significance either. Should it be treated? Does it cause a higher incidence of complications? Recent research has shown that, compared to people without the condition, a higher proportion of people who have white coat hypertension go onto develop high blood pressure later in life. So perhaps the best way to look at it is a warning, a form of 'pre-hypertension' that is signalling you to take precautions or else end up with high blood pressure.
In which case, if you have been diagnosed with this condition, instead of reassuring yourself that you are in fact fine, consider making some lifestyle changes to reduce your chances of developing full blown hypertension.
Please keep a close eye on your blood pressure, have a look at our information on other parts of this site and make up your mind to live a blood pressure friendly lifestyle.
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