White coat hypertension (white coat syndrome) is when patients' blood pressure (BP) readings are high in clinical settings and normal in other settings.
High blood pressure is thought to increase the risk of heart attack and stroke by damaging the blood vessels the way water rushing through a narrow pipe causes more damage the higher the pressure. Checking a patient's blood pressure is one way to detect a risk factor that can be addressed and controlled.
But what if patients with white coat hypertension learn to relax for a few minutes before the BP reading, or to avoid a big meal, alcohol and caffeine for at least 30 minutes, and then enjoy "normal" readings at every clinic visit?
If patients' blood pressure rises in clinical settings, it likely also rises in stressful settings outside the clinic: when under a deadline at work, cut off in traffic, upset with their children, or unable to find their check book. If true, blowing off a high reading at the clinic as "white coat hypertension" means losing an opportunity to address the risk factor and decrease the chance of a stroke or heart attack.
I often took multiple BP readings in my office and had patients obtain multiple readings on home monitors during both calm and stressful situations. Such accurate readings lead to optimal treatment decisions.
As a Healthy Survivor, you want your healthcare team to have accurate information about your health between office visits. If you tell your healthcare team "I'm fine!" when you are not, you'll lose opportunities to make things better.





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