Tips/suggestions for white coat hypertension

[Anonymous]

I have severe white coat hypertension and my BP was 159/110 today in the office. I told them I cried on the way to the office and am anxious at appointments but felt like a scarlet letter. This office is not my GP’s office. I told them my doctor wants me to start taking measurements at home so I have a log of these numbers and not just a one time in-office visit.

I don’t know what my question is but anyone have advice/thoughts? It wasn’t an old school cuff and was an electronic one. My GP said the electronic ones are not as accurate as the old school devices.

[Anonymous]

Are you asking how to lower your BP in the doc's office? Request a manual cuff, and ask them to wait until after your questions/weigh-in, etc., so you will have a chance to settle in.

As for the anxiety itself, therapy, meditation, breathing exercises, and visualizations/mantras have all been useful to me. It's not the sort of thing you want to start trying to treat with meds (trust me). Journaling is also useful. I noticed a pattern of anxiety in the days/weeks leading up to appointments. Now I know that's just part of my process, I thank my anxiety for looking out for me, and I reassure myself that I'm capable of making good decisions about my care plan and providers.

Fire anyone who doesn't support you in this, or rolls their eyes (yes, this happened to me) when you mention it. These people work for you.

[Anonymous]

Take it at home so you know whether you actually have high BP. If you have high BP, treat it. If you don’t, then who cares if it’s high at the office. Just tell them. If you’re worried they are judging you, they aren’t.

I am very anxious at the doctors as well, and it does tend to be higher there. But if you have anxiety at the doctors office, I don’t think you can really do anything to make it lower. You just make it worse by worrying about trying to make it better.

[Anonymous]

I had it always. Typically 140/90. Doctor would take a second reading after several minutes and it usually was 123/75.
But I have to tell you by the time I was 65, the inherited tendency to hypertension I have wasn't just manifested in white coat and I take 150 mg Irbesartan.

[Anonymous]

Just do the log at home, then you’ll have a lot more data. They just want to make sure you don’t have consistent high BP.

I really don’t think it’s a “scarlet letter” that you cried about your doctors appointment, I think it’s a big flag of concern. Are you seeing a therapist at all? They probably seemed worried about you because they’re worried about you. Which isn’t judgment, it’s care.

[Anonymous]

My doctor takes it at the end of my appointments. It’s normal then, but always high at the beginning.

[Anonymous]

Being afraid of having hypertension can bite you if you really are developing it. Better to treat it than run around frantic you will "get caught." I know. Btdt.

[Anonymous]

OP here. Thank you all so much. This is honestly fantastic feedback. I did take it at home and it was 124/86 so the bottom number isn’t great but it was a long day. I will start logging it at home daily so I have a record of what the readings are at home and if I need to treat it.

My daughter is in college (freshman) and she’s sick and I am a fed employee and am worried about a furlough - so the crying happened and I think they were just concerned.

[Anonymous]

There are some things you can try that may help you get lower readings, but it’s possible that you’re experiencing these spikes in bp every time you’re upset about anything, so if you ever have high enough readings consistently that a doctor raises the possibility of taking medication, you may want to try it.

I’ve had white coat syndrome for decades. Like a pp, my doctor takes my bp a second time, at the end of a visit, if the nurse’s initial reading is high. It’s always lower then.

Here are some tips than can possibly keep the first reading from spiking quite as high.

-Go for a 15 minute walk before you leave for your appointment. Nothing strenuous, no incline or speed walking necessary. Your bp will be lower after getting a little exercise.

-Arrive early so you can check in with reception 15 minutes before your appointment to give yourself time to decompress from traffic and relax a bit before you get called back. This is not the time to check emails.

-Don’t sit with your legs crossed. Anything that restricts your circulation can mess with your reading.

-Take slow, even, deep breaths. Consciously regulating your breathing can help relax you.

-When that cuff is placed on your arm, close your eyes and think of something that is super relaxing to you. It could be getting a massage or petting your dog or swaying on a porch swing or your mom brushing your hair when you were little. Whatever is the most relaxing thing you can conjure, mentally put yourself there and keep taking those slow breaths.

[Anonymous]

PP thank you! This is the nicest set of responses. I really appreciate it.

[Anonymous]

Anonymous wrote:OP here. Thank you all so much. This is honestly fantastic feedback. I did take it at home and it was 124/86 so the bottom number isn’t great but it was a long day. I will start logging it at home daily so I have a record of what the readings are at home and if I need to treat it.

My daughter is in college (freshman) and she’s sick and I am a fed employee and am worried about a furlough - so the crying happened and I think they were just concerned.

I’m sorry; that is a lot of stress! I hope your dd feels better soon and by some miracle, we can avoid a shutdown.

[Anonymous]

Also, don’t talk when you’re having your BP taken - it can raise it.

[Anonymous]

I have white coat hypertension and I do a lot better when they take it by hand. My theory is I developed a negative association with the machines when I had pre-eclampsia. I take my BP at home for a few days before every appointment.

[Anonymous]

Take it every day at the same time at home once you've sat quietly for 10 minutes. Keep a log for a month.

[Anonymous]

But do take the post about if it spikes every time you get upset...

I am like that as well. I get upset a lot. So although I could do all sorts of things to get a lower reading at home or even in the office, what was the point. I was walking around spiked. My dad died at 57 from hypertension, strokes. I am glad to finally be on. Irbesartan. The btdt person.