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Blood Pressure & White Coat Syndrome
Old 06-27-2006, 10:45 AM   #1
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Blood Pressure & White Coat Syndrome

I apparently have terrible white coat syndrome. No matter how many supplements I take, hot baths, tranquilizers, etc my readings are always sky freaking high at my cardiologist and primary doctor's office. At my *female* doctor I get low/normal readings. Maybe because doctors dealing soley with female issues are non-threatening.

I went to see my caridologist a month ago and my BP was at an all time high of 168/90 She told me to record my values for 30 days and fax it in to her. If my average turns out to be high, she'll put me on medication. I don't drink alcohol, run 20-25 miles a week, weight train and eat healthy.

I have a Omron HEM712C digital BP machine at home and my average reading is 110/70. The low end is 100/60 and the high end is 120/80. What gives? I don't feel nervous when I visit my primary care doc or cadiologist. I feel great, yet my readings come in at scary levels.

Is anyone else here dealing with white coat syndrome?
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 10:56 AM   #2
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Re: Blood Pressure & White Coat Syndrome

My dad has it big time. He measures his own blood pressure or has it done at the pharmacy and its always ok. Anytime he does it at the doctors office, its high. Doctor gave him a pill for it that made him sick. So he stopped taking it. He's convinced that the person taking the blood pressure at the doctors office just doesnt know how to do it.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 11:00 AM   #3
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Re: Blood Pressure & White Coat Syndrome

Wonder if it could be just the difference in environment. At home you are measuring BP while you are at rest and relaxed. At the doc's office (if you're anything like me) you have just finished rushing over there to/from work, fighting traffic, stressed from work, dreading bad news, got no time for dr's appts, dreading the long wait, etc.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 11:01 AM   #4
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Re: Blood Pressure & White Coat Syndrome

Cube,

This is very common. "Labile hypertension" is another term. Couple of tips:

1. Neither you nor the doctor/nurse should speak during the blood pressure taking. This may help.

2. Forget about trying to initiate a "relaxation" response while it is being taken -sometimes only serves to raise pressure further (though regular meditation practice may be beneficial). Kind of a vicious circle: high reading -> situation anxiety -> high reading, all of which then snowballs. Just quitely watch it being taken, period.

3. Ask about "ambulatory monitoring" for a week or at least a few days before commiting to taking medication, if your doctor agrees it is safe to do so. Home readings are helpful, but knowing that it really "counts" may have a similar white coat effect. The gizmos are worn all day and take a reading every 15 minutes under all your daily circumstances and after a few hours you forget you're wearing it.

While it is recognized that even labile hypertension carries some increased risk of the usual complications, it is not as strong a risk as sustained hypertension. And, there is no really good evidence showing that treatment lowers this milder risk (though it is plausible that it might).

The doctors who've seen you will know best, but I hope this general information is helpful.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 11:33 AM   #5
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Re: Blood Pressure & White Coat Syndrome

I heard about the ambulatory readings and understand it's pretty effective in distinguishing between real life BP readings versus in the Dr's office under duress I'm afraid to see what my readings are during the day at work.

There are times where I actually felt my BP rise (at work only - what a surprise) and my head feels like a pressure cooker. I really try to not get to that level. It's all about attitude. Attitude controls the mind/body connection to some degree. My attitude lately with work is: "My work place is a circus and I'm sitting here chomping on popcorn, enjoying the animals and laughing my a$$ off at the clueless ringleaders." This mantra seems to be working for me so far.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 11:41 AM   #6
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Re: Blood Pressure & White Coat Syndrome

Either way, you'll be fine. If it turns out you indeed do have some form of high blood pressure, join the other 30-40 million, surrender to it, take care of it and you'll be fine. If not, obviously that's ideal also great.

The real trouble comes for those who have it and don't know it, or who know it and refuse to get it treated - that'w where we often see the premature strokes, kidney failure, and the rest.

It could be alot worse.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 11:55 AM   #7
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Re: Blood Pressure & White Coat Syndrome

cube_rat,
I have OMRON model HEM-705CP and it has a little printer attached.

I do twice daily 8AM and 4PM, readings are always 110-115/60-75 range.

I go to the cardiologist and bang 160/95, he even did both arms. I'm very calm about doctors and visits but even my heart rate was 80 and it's normally 50-55.

So what gives? I walk up gradually sloping streets at a brisk pace and about 40 miles a week. I eat no salt, no fat, no caffiene.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 12:09 PM   #8
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Re: Blood Pressure & White Coat Syndrome

Quote:
Originally Posted by cube_rat
I apparently have terrible white coat syndrome.* No matter how many supplements I take, hot baths, tranquilizers, etc my readings are always sky freaking high at my cardiologist and primary doctor's office.* At my *female* doctor I get low/normal readings.* * Maybe because doctors dealing soley with female issues are non-threatening.
Hunh, that's odd, my BP skyrockets when I'm in a hot bath with a female doctor.

Quote:
Originally Posted by cube_rat
If my average turns out to be high, she'll put me on medication. I don't drink alcohol, run 20-25 miles a week, weight train and eat healthy.
I have a Omron HEM712C digital BP machine at home and my average reading is 110/70. The low end is 100/60 and the high end is 120/80. What gives? I don't feel nervous when I visit my primary care doc or cadiologist. I feel great, yet my readings come in at scary levels.
Doesn't seem to be a problem until you get near a doctor!

But seriously, cube, you seem like a classic case of the white-coat syndrome. I was always borderline high at work & at the doctor's office (hot baths notwithstanding) and I remember several shipmates on portable BP devices 24/7 for weeks at a time.

The only effective cure-all was to avoid the environments that raised one's BP. Doctor's offices are a good start but in my case I also decided to avoid the workplace. ER has been 100% effective at lowering my BP.

Quote:
Originally Posted by cube_rat
Is anyone else here dealing with white coat syndrome?
I'm curious. Have any of you found yoga or meditation to be effective at reducing BP? Does the skill gained through those disciplines transfer to keeping one's BP under control during tense moments at the office?
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 12:14 PM   #9
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Re: Blood Pressure & White Coat Syndrome

Thanks for the note, R in T. I believe it's best to be a little pro-active about treatable issues suchs as BP, diabetes and high cholestorol.

OAP: Yeah, I with ya on this perplexing question. I never had issues or thought about blood pressure until I hit that mid-life female time at 41. My former primary care doc took my blood pressure one day and it was 140/85. She quickly prescribed Norvasc and told me to get my BP down or I was going to have a stroke That comment scared the bejezus out of me and I landed up not taking the Norvasc and went to my old primary doc who told me to monitor it.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 12:19 PM   #10
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Re: Blood Pressure & White Coat Syndrome

Quote:
Originally Posted by Nords

I'm curious. Have any of you found yoga or meditation to be effective at reducing BP? Does the skill gained through those disciplines transfer to keeping one's BP under control during tense moments at the office?
Yoga is awesome. Unfortunately, my time schedule is so tight these days, that I'll always seem to choose to do a fat burning exercise over yoga.

Meditation is something I've been looking in to. I read the "Relaxtion Response" - (can't remember the author) and was fascinated. I've tried the breathing exercise from Dr Andrew Weil's site and it's great. It's a natural tranquilizer.

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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 12:54 PM   #11
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Re: Blood Pressure & White Coat Syndrome

Quote:
Originally Posted by Nords
I'm curious. Have any of you found yoga or meditation to be effective at reducing BP? Does the skill gained through those disciplines transfer to keeping one's BP under control during tense moments at the office?
Bodian, Meditation for Dummies.

I refer patients to it all the time, if they appear receptive. Good book, practical, accurate and doesn't inundate you with spirituality, though references are there if that's your thing.

Powerful stuff for some.
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Re: Blood Pressure & White Coat Syndrome
Old 06-27-2006, 01:01 PM   #12
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Re: Blood Pressure & White Coat Syndrome

My doc measures it twice. I'm always higher the first time.
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