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White-coat hypertension: When to worry

If the thought of going to the doctor makes you a little nervous, imagine what it can do to your blood pressure. About 20 percent of people diagnosed with high blood pressure, or hypertension, actually experience a spike in pressure only for the few minutes they are in the examining room. Anxiety about a diagnosis or fear of becoming ill can cause people to tense up in the presence of doctors and nurses. This, in turn, triggers the release of stress hormones that send pressure soaring. The phenomenon is called white-coat hypertension.

White-coat hypertension can indicate a predisposition to constant high blood pressure, or it can mean nothing at all. One sign that the spike is temporary: Home blood pressure readings are consistently normal compared with readings at the doctor’s office. (Note: If you don’t have a home blood pressure testing kit, don’t rely on those at grocery stores and pharmacies. Overuse knocks off their calibration, and the busy store atmosphere may not be conducive to an accurate reading.) Another sign: Blood pressure readings are lower when nurses or healthcare providers other than the physician take the actual reading.

On the other hand, white-coat hypertension can signify trouble for people who, besides reacting strongly in a doctor’s office, experience similar reactions to other minor stressors, such as being caught in traffic or running late for an appointment. This could mean their blood pressure is high quite often—a big heart hazard.

If you find yourself getting upset or anxious at situations and events that you cannot control, then white-coat hypertension may indicate a serious problem. Talk to your doctor about medication and lifestyle changes you can make to keep your blood pressure under control.