White Coat Syndrome
What is white coat syndrome?
White coat syndrome is a very common condition, in which a patient experiences high blood pressure and heightened anxiety when in a clinical situation. At other times, the patient's blood pressure may be completely normal; however, when visiting a medical professional, the readings are elevated. White coat syndrome could affect as much as 1 in 8 patients to varying degrees.
Feeling nervous when visiting the doctor may seem entirely natural to many patients. However, white coat syndrome can have serious effects. If a patient's blood pressure is elevated, procedures or treatments may be cancelled or postponed, meaning that the patient doesn't get the medical attention they need. Some estimates say that up to 1 in 8 patients suffer from white coat syndrome to varying degrees.
How much does white coat syndrome affect blood pressure?
Of course, the precise effects of white coat syndrome vary from patient to patient. However, an increase in blood pressure is a feature of this condition. The difference in blood pressure when measured at home and at the doctor's office can be vast. At home, the top (systolic) number could be, on average, 10mmHg lower than at the doctor's, while the bottom (diastolic) number could be 5mmHg lower.
These are only averages. Depending on the patient, the difference could be much larger. In fact, some patients could see differences of up to 30mmHg. That makes it difficult for a doctor to measure if a patient really has high blood pressure, or is merely suffering from white coat syndrome.
Does anxiety raise your blood pressure?
Yes. Studies have seen patients fitted with 24-hour blood pressure monitors, which measure the changes in blood pressure over a continuous period. Blood pressure readings can change significantly, depending on the levels of anxiety or stress a patient is experiencing. High blood pressure (hypertension) is a permanent problem for some patients, but temporary spikes are common when experiencing anxiety.
White coat syndrome can lead to ongoing problems with high blood pressure, making it important to monitor and treat the issue.
Treatment for white coat syndrome
First, it is important for patients to feel comfortable and relaxed before their blood pressure is taken. A patient should try to get to their medical appointment with plenty of time, and sit calmly while waiting to be seen. If white coat syndrome continues, a patient and doctor can discuss the possibilities of home blood pressure testing. This could give a more accurate reading.
Many treatments involve cooperation between the patient and the medical centre. The medical centre can work to ensure that the patient is always seen by the same doctors and nurses; familiar faces can help lower anxiety.
In some cases, blood pressure medication or beta blockers such as propranolol may be required. This should always be discussed with a doctor. Medical professionals are well aware of white coat syndrome and will try to identify it in patients before prescribing any medications. However, if the patient requires ongoing treatment for another condition, and their elevated blood pressure is causing problems, then medication might be necessary.