Some people may have normal blood pressure readings while at home; however, they discover they have high blood pressure at the doctor’s office. This is what is known as white coat syndrome, or white coat hypertension. This article will explain how to get rid of white coat syndrome with natural treatment and prevention methods.
A healthy blood pressure is a systolic reading of around 120 mmHg (millimeters of mercury) and a diastolic reading of 80 mmHg. High blood pressure is anything above that number.
White coat syndrome has been defined as high blood pressure in the doctor’s office only. The syndrome gets its name from the traditional white coats doctors and medical staff may wear while in a hospital or clinical setting.
Research shows that the prevalence of white coat syndrome may be as high as 20% to 45% of those diagnosed with high blood pressure.
We’ll take a closer look at white coat syndrome, including its causes, risk factors, and how it compares to normal hypertension.
In This Article:
What Causes White Coat Syndrome?
It is common for patients to experience some anxiety during a doctor’s visit, which can spike your blood pressure. Many can relate to that nervous feeling, where we judge ourselves for not doing enough to be healthy.
At the same time, it is quite normal to be anxious while anticipating the prospect of getting poked with needles, and probed or hooked up to test equipment.
It is no wonder why you may ask in such a situation, “Do I have white coat hypertension?”
Although it is true that you may have the condition, this leads some to believe that white coat hypertension isn’t really a problem, and that your blood pressure will normalize once you leave the doctor’s office.
But, some doctors believe that white coat syndrome is a risk factor for developing long-term high blood pressure or a serious heart problem like heart disease.
This is why you may also experience what is known as a high white coat syndrome heart rate. A study published in the Journal of the American College of Cardiology in 2015 found that those with white coat syndrome had an increased risk of heart failure, stroke, heart attack, and other cardiovascular conditions.
Research also shows a possible link between sleep apnea and white coat syndrome. People with both problems had more difficulty falling asleep and longer periods of waking up in the middle of the night.
White Coat Syndrome Risk Factors
White coat syndrome appears to be more common in both women and older patients. Research shows that among people aged 60 and older, there were more heart problem cases in those with white coat syndrome than in people without this type of high blood pressure.
Some people experience high blood pressure due to other factors like an emergency, work stress, the loss of a loved one or another type of life trauma, or not taking your blood pressure medications for a number of days.
Although genetic factors can play a role with hypertension, there is little debate that diet, lifestyle, and environmental factors are underlying causes of high blood pressure.
A diet high in sugar, fat, and salt and low in fiber and omega-3 fatty acids may also increase blood pressure. Caffeine, alcohol, smoking, obesity, inactivity, and pregnancy or taking birth control pills may also increase your risk of hypertension. Exposure to heavy metals like arsenic, cadmium, lead, and mercury may also be a factor in certain patients.
White Coat Hypertension vs. Hypertension
This section will compare white coat hypertension vs. hypertension.
Regular hypertension is always present, whereas white coat hypertension is a high blood pressure reading in a clinical setting only.
Experiencing white coat hypertension doesn’t mean you have regular hypertension; at the same time, some people with hypertension don’t always have high blood pressure while at the doctor.
This is what is known as masked hypertension. It happens when your blood pressure reading is normal in the doctor’s office but higher in other settings.
Research published in the journal Circulation in 2016 actually shows that masked hypertension is 16 times more common than white coat hypertension. Consequently, many hypertension patients may be at risk of slipping through the cracks because their readings are too low while at the doctor.
In a nutshell, hypertension is difficult to diagnose. That is why, to rule out white coat syndrome or to determine masked hypertension, your doctor may suggest ambulatory blood pressure monitoring, which continuously measures blood pressure.
This can help determine whether you have high blood pressure on a regular basis, or just in the doctor’s office.
How to Get Rid of White Coat Syndrome
Knowing that your blood pressure might increase at the doctor may be a self-fulfilling prophecy in some way. Basically, when you worry that you’ll have high blood pressure, this may lead to anxiety and stress, which may boost your blood pressure at that time.
However, most doctors will not make a hypertension diagnosis from just one high reading. This is because prescribing high blood pressure medications from one high reading may lead to serious problems like hypotension—also called low blood pressure. This may lead you to pass out, or feel dizzy, lightheaded, or weak.
Not to mention that antihypertensive drugs like beta-blockers, diuretics, and angiotensin converting enzyme (ACE) inhibitors can lead to a number of other side effects like headaches, nervousness, constipation or diarrhea, losing or gaining weight without trying, and even erection problems in men.
Instead of making a high blood pressure diagnosis from one reading, your doctor may ask you to return several times over a month. This will help the doctor determine whether you have regular hypertension or white coat hypertension.
However, during the course of these doctor’s visits there is also a chance of white coat syndrome appearing again.
Furthermore, your doctor may have you monitor your blood pressure at home, which will more closely reflect your blood pressure from a day-to-day perspective.
Experts recommend that blood pressure be monitored after several minutes of relaxation while being comfortably seated in a chair with legs uncrossed. The back and arms should also be properly supported. You should not be talking, and the cuff should be placed on bare skin.
What Is the White Coat Syndrome Cure?
This section will show you how to get rid of white coat syndrome. The following are tips to ensure you have a normal reading before you strap on the blood pressure cuff.
1. Blood Pressure Devices
Devices used to measure blood pressure include sphygmomanometers, tensiometers, and automatic electronic measuring devices known as oscillometric devices.
Although automatic devices are more expensive, they are considerably more precise, since they take several measurements at a time. Researchers believe that automated measurements can help eliminate white coat syndrome.
These oscillometric devices will be able to detect individuals with true high blood pressure right at the doctor’s office.
2. Meditation or Deep Breathing
It can really help to calm yourself if you’re stressed or anxious during a blood pressure reading at the doctor.
Taking a few deep breaths beforehand can help you relax. Meditation is also a proven stress reliever that helps people handle anxiety and worry before a trip to the doctor’s office.
The best part is that a short 10- to 15-minute meditation can be done while waiting for the doctor.
3. Exercise and Yoga
Exercise is one of the best white coat syndrome stress relievers because it releases endorphin chemicals in the brain, which naturally improve mood. Regular moderate exercise has been found to reduce blood pressure and improve sleep.
Yoga in particular is known to reduce stress and anxiety, which is helpful before a blood pressure reading in the doctor’s office.
4. Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a therapeutic practice proven to lower stress and anxiety. CBT focuses on changing and challenging your thoughts, since your perception of an event such as going to the doctor’s office can certainly influence how your body reacts.
Once you identify the root thought pattern that causes your behavior, you can work on changing how you think about getting your blood pressure reading at the doctor’s office.
CBT may be ideal for the person who jumps to conclusions, or is pessimistic about their health and just assumes that their blood pressure is high.
5. Blood Pressure Diet
Diet plays a major role in the prevention of hypertension. The DASH (Dietary Approaches to Stop Hypertension) and the Mediterranean diet are the two most-studied diets to prevent and control hypertension.
Key characteristics of a blood pressure diet should be high-fiber foods, and those with key nutrients like calcium, potassium, and magnesium.
Overall, the whole foods and largely unprocessed diet should contain lots of vegetables; fresh fruit; lean proteins like wild-caught seafood; grass-fed and pasture-raised eggs; meats, beans, and legumes; and healthy fats like coconut oil, extra virgin olive oil, and avocados.
Final Thoughts on White Coat Syndrome
What should you take away from this guide to white coat syndrome?
White coat syndrome is a condition in which your blood pressure is high at the doctor’s office, often due to stress or anxiety; but your blood pressure reading is normal in other settings.
That being said, a condition like masked hypertension is about 16 times more common than white coat syndrome, according to research from 2016.
This article also showed you how to get rid of white coat syndrome with a few natural tips on how to prevent high blood pressure. This can be as simple as practicing deep breathing exercises and meditation, working out, or doing yoga before your doctor’s appointment.
Taking cognitive behavioral therapy, adopting a blood pressure diet, and using automatic electronic measuring devices could also help you avoid white coat syndrome.
Follow these tips during your next check-up or physical at the doctor’s office. When you do, white coat hypertension will likely not be a problem.
- Hypertension Diet: 10 Good Foods for High Blood Pressure
- Sudden High Blood Pressure: Causes, Symptoms and Prevention Tips
- Is Garlic Good for High Blood Pressure?
- Foods that Raise Blood Pressure
Article Sources (+)
Murray, M., M.D., et al., The Encyclopedia of Natural Medicine (New York: Atria Paperback, 2012), 666-667.
Chrysant, S.G., “Treatment of white coat hypertension,” Current Hypertension Reports, Aug. 2000;2(4): 412-417, PMID: 10981177.
Tientcheu, D., et al., “Target Organ Complications and Cardiovascular Events Associated with Masked Hypertension and White-Coat Hypertension: Analysis From the Dallas Heart Study,” Journal of the American College of Cardiology, Nov. 2015; 66(20): 2159-2169, doi: 10.1016/jack.2015.09.007.
“White Coat Hypertension – Causes and Cures,” Lower My Pressure; http://lowermypressure.com/white-coat-hypertension-causes-and-cures/, last accessed Dec. 8, 2017.
Schwartz, J.E., et al., “Clinic Blood Pressure Underestimates Ambulatory Blood Pressure in an Untreated Employer-Based US Population,” Circulation, 2016; 134: 1794-1807, doi: 10.1161/CIRCULATIONAHA.116.023404.
Daniel Jones, M.D., dean, school of medicine, University of Mississippi, Jackson, and spokesman, American Heart Association; Dec. 21, 2004, Hypertension, last accessed Dec. 8, 2017.
Dragan Kljujic, MA et al. How do family physicians measure blood pressure in routine clinical practice? Canadian Family Physician, March 2017 vol. 63 no. 3 e193-e199, last accessed Dec. 8, 2017.