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Dr. Andrew Rynne

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Suggest treatment for white coat syndrome

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6407 Questions

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Posted on Tue, 20 Oct 2015 in Hypertension and Heart Disease
Question: is there any cure or tips for "white coat hypertension"? my blood pressure gets really high each time I go to the doctor. I don't like needles and am a fainter. the would not let me leave last visit until it went down. the constant checking and rechecking caused me great anxiety and stress. I felt like I was wasting their time and bothering them. I saw a cardiologist later in the day. BP was a little high and EKG was "terribly normal" per the doctor. when I take my BP at home it is usually around 120/80.
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Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello XXXX!

Welcome and thank you for asking on HCM!

I understand your concern and would like to explain that your condition (white-coat hypertension) is generally harmless. It is not necessary to use antihypertensive therapy for controlling those isolated office high blood pressure values.

It is necessary that the diagnosis of white-coat hypertension be confirmed within 3–6 months. Additional investigations and close follow up should be done, including repeated out-of-office (ambulatory) BP measurements.

I would recommend that besides close ambulatory BP monitoring, an optimal management of potential cardiac risk factors be done (dyslipidemia, body weight control, glucose metabolism monitoring, avoiding close smoking contacts, following a healthy diet, etc).

From several studies, it has been concluded that "white-coat hypertension" patients are at intermediate long-term cardiovascular risk between true normotension and sustained hypertension.

So, you are just in time for improving your future CV profile by preventing potential cardiac risk factor to do any harm.

From the other side, as you refer of becoming faint or near faint when on a medical environment, you need to control your blood pressure values within 3 minutes of the standing position for ruling in/out a possible orthostatic hypotension (orthostatic intolerance).

Hope to have been helpful to you!

Feel free to ask me whenever you need!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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