blood pressure chart

What Is White Coat Syndrome?

Eli Ben-yehuda

Written by Eli Ben-yehuda

On May 15, 2019

It surprises me how many people suffer from white coat syndrome. In talking with and helping our customers I have learned it is a very prevalent problem in our modern world. From my own life, I can tell you that anxiety can be crippling and lead to such problems as hypertension.

Many anxious people have health and medical sensitivities. This can set them up for the ‘white coat syndrome.’ Being fearful of going to the doctor and finding out their worst fears about their health have come true.

Because of this, people with anxious personalities would rather not know about a serious medical condition. They fear they would have to face it and deal with it. While this approach may seem beneficial, it works against them. Thus fueling anxiety and anxiety disorders.

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Anxiety occurs when you imagine and fear the worst. The more you don’t know, the more anxious people worry. The more they worry, the more hyperstimulated their body becomes. It is the perfect recipe for a struggle with anxiety disorder and its sensations and symptoms.

Some people may have normal blood pressure readings when they are at home. But once in their doctor’s office, they discover they have elevated blood pressure. This phenomenon is known as White Coat Syndrome or White Coat Hypertension. This article will explain how to lessen the effects of white coat syndrome with natural treatment and prevention methods.

White Coat Syndrome Vs. White Coat Effect

White Coat Syndrome may affect up to 30 percent of Americans. It occurs when the blood pressure reading at the doctor’s office is higher than it is when checked at home. It was once thought that it was just the temporary stress of being at the doctor that caused a spike and that it didn’t indicate a bigger problem.

But the risk of death was nearly twice as high for patients with white coat syndrome! This is compared to patients whose blood pressure is normal when taken at the doctor’s office and at home, the report published in the New England Journal of Medicine.

According to Dr. Haitham Ahmed, medical director of cardiac rehabilitation at Cleveland Clinic, “White coat syndrome is not benign.” He was not a part of the study. “If seeing a white coat increases your blood pressure, a lot of other stressors in life are expected to as well.”

The term “white coat syndrome” is used to describe the patient who has persistently elevated clinic or office blood pressure (higher than 140/90 mm Hg). They have a lower daytime ambulatory blood pressure (lower than 135/85 mm Hg) at home. The term “white coat syndrome” is reserved for those who are not receiving antihypertensive drug therapy. We should distinguish it from the white coat effect, which is a common response to an office visit.

White coat effect

The white coat effect can be observed in most hypertensive patients as an elevated office blood pressure. When taken at home it is much lower. This occurs regardless of the presence or absence of hypertension. White coat effect tends to be most apparent with the initial blood pressure measurement. But it can be observed in multiple provider-measured blood pressures during an office visit. In most cases, the white coat effect represents patient anxiety about the office visit. It may result in misdiagnosis of hypertension or the severity of hypertension and may lead to overly aggressive therapeutic measures.

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Both white coat syndrome and white coat effect can be countered by the use of an automated and programmable oscillometric device that enables the determination of multiple readings in the home.

Here are a few tips to help you alleviate “White Coat Syndrome”

4-7-8 Breathing: According to Dr. Andrew Weil this is the single best fix he has found for anxiety. It is a simple technique that seems to stop inner turbulence in its tracks. Almost immediately creating a calm inner peace that tames the fight-or-flight response. 4-7-8 cools your body’s inflammatory reaction to all those stress hormones. Dispersing anxiety and panic, I could quite accurately compare it to a twenty-minute meditation sitting on the physiological front. You simply breathe in through your nose for four seconds, hold your breath for seven seconds, and exhale through your mouth for eight seconds.

How to practice the 4-7-8 method

    Beet juice contains nitrate, a component that dilates blood vessels and increased blood flow. Participants in a study conducted by St Bartholomew’s Hospital in London showed a decrease in blood pressure in less than one hour after drinking 20 oz. of beet juice. In 2.5 hours, the participants saw a significant reduction in blood pressure.

    Take a brisk walk for at least 15 to 20 minutes

    At least 30 minutes of physical activity five days a week can reduce blood pressure overall and is effective for managing hypertension. A patient may not have the time necessary for regular exercise to have a significant effect on blood pressure before a test. However, even a short walk produces rhythmic breathing. This decreases blood pressure by calming the body’s stress response. Moreover, the extra oxygen increase helps the heart use oxygen more efficiently, thereby reducing the stress or pressure on the heart.

    Drink a glass of water

    Water has a calming effect on the nervous system, and water flushes out sodium, an element that increases blood pressure. Drink a larger portion of water at one time, rather than sipping on water at several intervals during the day. Sipping water throughout the day is good for staying hydrated. But for a faster effect on blood pressure, drink a glass of water for direct calming effects and a drop in blood pressure.

    Eat a banana or other potassium-rich food

    Potassium is an electrolyte and plays a significant role in some of the mechanisms that control blood flow and heartbeat. Potassium supplements may take four to six weeks before having an impact on blood pressure. Depending on how fast the body metabolizes the foods rich in potassium, blood pressure may drop within an hour or two of eating a potassium-rich food. See Resources for a list of potassium-rich foods.<

    Avoid unhealthy foods and habits before visiting the clinic for testing

    Refrain from smoking at least one hour before the appointment. Smoking decreases oxygen intake and makes the heart work harder. Avoid fatty meals, which often contain too much sodium and increases blood pressure. Do this at least two days before your physical.

    Take a nap before testing or visiting the clinic

    Research conducted at the Liverpool John Moores University in Liverpool, U.K., found that naps reduce strain and pressure on the heart. Take a nap, no longer than one hour long, before an appointment for testing.

    Avoid making a morning appointment and tell the clinician about testing anxiety

    Morning hypertension is common, as blood pressure is higher in the morning. Do to this Many patients experience a white coat syndrome. Their blood pressure may increase at a doctor’s office beyond its average level.

    Some of the antidotes used for short-term use may yield long-term results if used regularly. Patients who show borderline hypertension, a reading that is just over the threshold of the ideal, may still get a passing score. Results of any testing do not automatically authorize or reject a candidate. The board that oversees the candidate’s application, such as an employer or a school athletic department, can usually qualify a candidate by reviewing the application as a whole.

    White coat hypertension is more dangerous than being pre-hypertensive. Sudden blood pressure spikes can lead to stroke or heart attack. If you believe you are suffering from white coat syndrome speak with your physician. Your physician might be able to help you manage the condition.

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    Written by Eli Ben-Yehuda

    With a passion for health advocacy Eli researches and writes many articles concerning improving the lives of people diagnosed with high blood pressure and the complications they experience. He believes educating people is the best way to improve their overall health.


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