Understand White Coat Syndrome: Definition, Causes, Diagnosis, and Cure

Key Takeaways

* WCH occurs in 15-30% of people, causing elevated blood pressure during doctor visits.

* If BP is higher at the doctor's office than at home, it may be WCH, leading to potential misdiagnosis.

* Understanding WCH involves recognizing its symptoms, causes, and the importance of accurate readings.

* Management and prevention include relaxation techniques, lifestyle changes, and open communication with your doctor.

Introduction

White coat hypertension causes high blood pressure readings at the doctor's office about 15-30% of the time. If your blood pressure is higher at the doctor's office than at home, you may have white coat hypertension. This can lead to misdiagnosis of hypertension.

Hence, let's understand white coat syndrome, its symptoms, causes and diagnosis. We will also provide you with some tips to manage it.

What is white coat syndrome (hypertension)?

a woman getting a high BP reading in front of the doctor due to whitecoat hypertension
Image by Freepik

White coat hypertension (WCH), also called white coat syndrome, is the phenomenon of getting high blood pressure readings when the doctor is checking your BP. But your blood pressure at home or in other settings is normal. The name white coat is because the doctors who measure blood pressure often wear a white coat.

Normal blood pressure falls below 120/80 mm Hg, while readings surpassing 130/90 mm Hg indicate hypertension. In the case of white coat hypertension, your home monitor may show readings below 120/80 mm Hg. However, readings at the doctor's office could surpass 130/90 mm Hg.

White coat hypertension might not seem a major issue. However, every year, doctors diagnose hypertension in about 5% of people who actually have white coat hypertension. This might lead them to prescribe medicines that you do not need, leading to side effects like hypotension (abnormally low BP).

WCH may also signal a risk of developing hypertension in future and increased cardiovascular and organ damage risks.

White coat hypertension causes

We all are anxious when visiting the doctor's office. But some people are more susceptible to it than others. For example, seeing a doctor may trigger the "flight or fight" response in some individuals, resulting in a surge in blood pressure.

People who have had negative experiences with doctors are more likely to experience WCH. Anxiety about blood pressure checks at the doctor's office increases the likelihood of WCH.

The other things that may affect your blood pressure are:

  • Time of the day
  • Your activity levels
  • Stress
  • Smoking, caffeine or alcohol consumption
  • Anxiety
  • Your emotional state

Symptoms of white coat syndrome

White coat hypertension does not present any symptoms. You may feel stress or anxiety that may be increasing your BP. 

White coat hypertension: diagnosis and tests

When your blood pressure seems high at the doctor's office, they might want to monitor it over the next few weeks or months. But If you've experienced white coat hypertension before, it could happen again. Hence, your doctor might recommend checking your blood pressure at home to make things more transparent.

A chart showing how to diagnose white coat syndrome.
Pic credit: https://www.researchgate.net/figure/Detection-of-white-coat-hypertension-or-masked-hypertension-in-patients-not-on-drug_fig1_321047308

You can do it with a home BP monitor, which you can purchase online or from a pharmacy store. Using this monitor, you can take multiple readings daily and show them to your doctor for their opinion.

Another option is to get an ambulatory blood pressure monitor. You can strap this device to your body and wear it for a day to 2 days. It measures your BP every 20-30 minutes after wearing it. 

Hence, by comparing your BP readings at home with those you get at the doctor's office, your doctor can diagnose you properly.

Tips for white coat hypertension management

Avoiding white coat hypertension can give you a more accurate reading and prevent misdiagnosis. You should follow these simple tips to beat white coat hypertension.

  1. Don't worry about the results: WCH can create a self-fulfilling prophecy, as worrying about a high blood pressure reading during measurement can result in elevated BP.
  2. Give yourself time to relax: If you are anxious, you can ask the doctor to give you a few minutes to calm down and relax.
  3. Practice breathing exercises: Breathing exercises are excellent to relax your body and deal with anxiety. So, learn some breathing exercises and practice them before entering the doctor's office.
  4. Change the topic: Discussing blood pressure can be stressful. You can either try to discuss something else with your family member or don't talk.
  5. No smoking or caffeine consumption: Smoking and caffeine can temporarily increase your blood pressure reading. Make sure you don't take these things before going to the doctor.

White coat hypertension cure

Your doctor would only treat hypertension only if you have other lifestyle diseases like diabetes. Primarily, white coat hypertension treatment involves lifestyle changes to improve your heart health. Some changes you can make include:

  • Practice relaxation techniques before doctor visits
  • Engage in regular physical activity
  • Maintain a healthy and balanced diet
  • Limit caffeine and sodium intake
  • Get adequate and quality sleep
  • Manage stress through activities like meditation or deep breathing
  • Establish a trusting and open relationship with your doctor to discuss fears or apprehensions

White coat hypertension prevention

The best way is to follow the tips for managing white coat hypertension. You can also communicate with your doctor. Talking to them about your concerns and getting assurance can help you destress and may improve your blood pressure reading.

FAQ

Is white coat syndrome real?

Yes, white coat syndrome is real and affects about 15 to 30% of people who get their BP checked in the doctor's office.

Is white coat syndrome dangerous?

Yes, white coat hypertension may potentially be dangerous. If you have white coat hypertension, your chances of developing hypertension is higher in the long run. Also, it might lead to a misdiagnosis of hypertension, leading you to start hypertension medication without having the disease. 

Also Read: A Guide On Hypertension

Does anxiety disorder cause high blood pressure?

Having anxiety does not cause long-term hypertension. However, it can spike your blood pressure when you are feeling anxious. Hence, having an anxiety disorder may cause WCH if you feel uneasy during a doctor's visit. 

Conclusion

Understanding white coat hypertension is crucial to avoid potential misdiagnosis and unnecessary medication. In 15-30% of cases, this phenomenon manifests as elevated blood pressure during doctor visits but normalizes elsewhere. Mistaking it may lead to unwarranted hypertension treatment and associated side effects.

By following tips and fostering open communication with your doctor, you can manage WCH, ensuring accurate readings and personalized care.

Consider using the Aware Health Rewards app to track your BP and improve your heart health. Along with tracking, Aware also provides daily nudges to improve your health and prevent you from developing hypertension. Download the Aware Health Rewards app today!

Share this post
Aware App Icon
Download Aware: The #1 health app for a strong and healthy heart.

Related Articles

Hypertension

19 Tips on How to Control High BP at Home.

Discover 19 hypertension self-care tips to manage high blood pressure at home efficiently. Avoid hypertension complications and live healthily.
Lucky Mehtani, B. Pharm.
February 7, 2024
Hypertension

Mercury BP Machine: Price, Overview, and How to Check BP With It

Choose mercury BP machines for precision. Master home blood pressure monitoring with expert insights.
Lucky Mehtani, B. Pharm.
November 10, 2023
Hypertension

Top 9 Foods That Raise Blood Pressure: Avoid These High BP Foods

Discover the daily foods that increase blood pressure to maintain good heart health. Get answers to common questions about high blood pressure.
Lucky Mehtani, B. Pharm.
October 13, 2023