- Buy a portable blood pressure (BP) monitor and measure your BP multiple times at home.
- Your doctor may recommend an ambulatory blood pressure monitor that you wear for 24 hours or more.
If the readings in the medical setup are ≥140/90 mmHg but <130/80 mmHg at home, you have white-coat hypertension.
What Is White-Coat Hypertension?
- Traditionally, doctors and nurses wear white coats.
- Hypertension means high blood pressure.
- White-coat hypertension (WCH) is a condition in which a person’s blood pressure is higher when measured in a clinic or hospital but normal when checked at home or in a neutral setting.
- It is thought to be caused by anxiety, stress, or nervousness that comes from being in a medical setup.
- While WCH is called hypertension, the person has a normal BP otherwise. So it is not a serious problem.
- If you have WCH, your doctor may wrongly put you on blood-pressure-lowering medicines unless it is diagnosed. It also has adverse implications for some jobs and insurance premiums.
- Nearly fifteen to thirty per cent of hypertensive people have WCH. That means, unless WCH is ruled out, many people receive incorrect treatment. You don’t want to be one of them.
White-coat hypertension is more common in:
- Older adults;
- Non-smokers; and
- People with a family history of high BP.
What Causes White-Coat Hypertension?
The exact cause of WCH is unknown:
- Some people get WCH in a clinic or hospital setting;
- Some others show WCH when a medical authority like a doctor or a nurse measures BP.
How is White Coat Hypertension Diagnosed?
- Measure your BP several times a day at home for a week and keep notes of the date, time, and readings.
- Instead, you can take a 24-hour ambulatory blood pressure monitoring (ABPM) test, which involves wearing a small, portable instrument that measures your BP every fifteen minutes in the daytime and every sixty minutes in the night over 24 hours. This, along with how fast your heart is beating (heart rate) at the measurement time, gives a good understanding of your BP pattern.
If the readings in the medical setup are ≥140/90 mmHg but <130/80 mmHg at home, your doctor will make the WCH diagnosis.
Treatment for White-Coat Hypertension
- If WCH is not a ‘real’ hypertension problem, why should it be treated? Research shows that if untreated, people with WCH have an increased risk of developing heart disease and stroke over the long term. This is especially true in higher-risk groups such as men and diabetes patients.
- To reduce WCH, your doctor may advise you to reduce anxiety with relaxation techniques or medicines.
- Your doctor may also prescribe BP-lowering medicines.
- You have to check your BP at home on a regular basis to ensure that your WCH does not turn into sustained (conventional) hypertension.
- Finally, it is a good idea to follow the lifestyle changes advised for hypertension: Regular exercise, adequate sleep, low stress, no smoking, limited alcohol consumption, healthy diet and proper weight.
While we are at it, what if your BP is normal in your doctor’s clinic but elevated in your house? That is worse than WCH since your doctor will think that you are normal and won’t treat you but in reality, you are hypertensive. It is called Masked Hypertension, which we will discuss in some other article. It is called Masked Hypertension, which we will discuss in some other article.
To Read More
- Hypertension Journal: White-Coat Hypertension: New Insights From Recent Studies
- MedicalNewsToday: What is white coat syndrome, or white coat hypertension?
- Cedars Sinai: White-Coat Hypertension and Masked Hypertension
- On this Website: Controversies in Medicine: When Is Blood Pressure Considered High?
- On this Website: Does alcohol consumption affect blood pressure?
First Published on: 25th May 2023
Image Credit: Image by Iaros on Freepik