White Coat Syndrome?

What is White Coat Syndrome, and how do you avoid it?

The Scenario:

As you wait in the doctor’s office, anxiety sets in, and you can feel your heart racing. The echoes of footsteps and opening doors keep you on high alert.

The Response:

When your practitioner enters and the rolling blood pressure cart comes into view, you tense up. As the blood pressure cuff begins to tighten and measure your levels, your shoulders stiffen, and maybe start to breathe from your chest in quick bursts.

Your body reacts to this situation as a threat and pumps up your adrenaline– as if you’re running from a lion (or tiger, or bear, oh my!). You’re launched into fight or flight mode.

Sound familiar?

Frustration sets in when an abnormal high blood pressure reading lights up the screen. You can’t understand how this is possible when your blood pressure is always normal at home.

So, what is that? Why is that happening?

What you are experiencing is White Coat Syndrome.

At home, your blood pressure is consistently normal, but in any clinical setting, it is always high.

Let’s break it down:

Understanding Blood Pressure Numbers
According to The American College of Cardiology Revised 2017 Guidelines:

• Normal blood pressure: Less than 120/80 mm Hg
• High blood pressure (also referred to as Hypertension): Greater than or equal to 130/80 mm Hg.
• Systolic blood pressure: The top number, which measures the pressure the arteries experience when the heart is beating.
• Diastolic blood pressure: The bottom number provides the amount of pressure while the heart is between beats and resting.

What Steps Can You Take To Prevent White Coat Syndrome?

Before Your Visit:

1. Have questions prepared for your doctor– this will help to reduce the anxiety of potentially forgetting to relay an important point regarding your health.
   
2. Do whatever relaxes you the morning of–or before heading out to your appointment. Meditating, deep breathing exercises, listening to music, or taking a walk are all great ways to decompress.
   
3. New physician and trying to navigate a large medical complex? Try going before the day of your appointment to make sure you’re familiar with the location, parking, etc.
   
4. Plan to arrive early– ensuring have have plenty of time to park and settle in at the office, and ease the stress of getting to your appointment on time.
   
5. Reframe the way you perceive stress to mitigate its effects. The work of research psychologist, Kelly McGonigal, encourages us to think of stress as our body’s way of rising to a challenge.

At your visit:

1. Request to have your blood pressure taken a second time once you are more relaxed.
2. Bring a trusted family member or friend into the exam room with you for support. Bonus: Have them tell a joke or a funny story to help calm you.
3. Practice deep diaphragmatic breathing: Breathe in through the nose as your belly expands as much as possible, and then breathe out through the mouth while your belly completely deflates.
4. Distract yourself: Think about the lyrics to a song, words to a poem that you love, count backwards, or wriggle your toes!
5. Imagery – picture yourself in a place that you find peaceful.
6. Advise any practitioners that you see of your normal blood pressure readings at home. Provide them with the dates and numbers of your recent blood pressure readings to ensure you are not prescribed unnecessary medications.

Looking for support in managing your stress?
Schedule a free Health Talk with one of our board-certified health coaches!