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How To Find Out If You Have White-Coat Hypertension

If you have white-coat hypertension, you will be put on hypertensive medicines wrongly. You may also face issues with your job and insurance premium.

Executive Summary

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.

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 high (≥140/90 mmHg) but normal (<130/80 mmHg) at home, you have white-coat hypertension.

Hypertension means high blood pressure. Nearly 15 to 30 per cent of patients diagnosed as hypertensive don’t have a high BP problem. That means such people receive incorrect treatment. You don’t want to be one of them.

What Is White-Coat Hypertension?

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.

Traditionally, doctors and nurses wear white coats. White-coat hypertension 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 most of the time. So it is not a serious problem. White-coat hypertension is more common in:

  • Women;
  • 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; others show WCH when a medical authority like a doctor or a nurse measures BP.

How To Diagnose White Coat Hypertension?

If you have WCH, your doctor may wrongly put you on blood-pressure-lowering medicines unless it is detected. It also has adverse implications for some jobs and insurance premiums. So it is important to rule out WCH if you are diagnosed as a high BP patient.

  • 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 high (≥140/90 mmHg) but normal (<130/80 mmHg) at home, your doctor will make the WCH diagnosis.

How To Treat 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 should check your BP at home regularly 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.

What if the converse is true? That is, what if your BP is normal in a 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. Read on this website: Why Should You Be Tested For Masked Hypertension.

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First Published on: 25th May 2023
Image Credit: Image by Iaros on Freepik
Last Updated on: 27th February 2024

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