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How To Deal With White Coat Syndrome?

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Posted on Mon, 6 Jul 2015
Question: when i take my bp at home it is always low. when i go to the doc it is high i have white coat syndrome. Any advise on how to deal with this?
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
Pharmacological therapy is not necessary. I advise you as follows:

Detailed Answer:
Hello!

Thank you for your question on HCM!

Regarding your concern I would like to explain that your symptoms seem to be caused by anxiety and a kind of fear when consulting with a doctor.

This is a very known phenomena, which occurs in up to 40% of the persons. The episodes of high blood pressure occur exclusively during doctor appointments and are accompanied with fear and anxiety.
White coat hypertension is a benign condition, and the organ damage from these episodes of high blood pressure has been evaluated in many studies to be non-significant ( just like in normal persons).

I would first recommend you to perform an ambulatory 24 hours blood pressure Holter monitoring and routine blood tests, liver and renal function tests, to exclude other causes of high blood pressure.

I would not recommend a pharmacological treatment for this disorder .

Instead, I would advise you to modify your lifestyle:
decrease your daily salt intake, reduce your weight, exercise regularly, avoid smoking, and correct blood glucose and lipid abnormalities if they are encountered in your check ups.

Some tips to lower your anxiety when consulting with the doctor would be also helpful:
- Psychotherapy
-Try not to change your doctor
-Avoid caffeine when going to the doctor
- Go to the doctor accompanied by a family person or a friend.

In addition I would recommend you to follow-up with ambulatory blood pressure monitoring every 6 months.

Hope to have been helpful!

Greetings! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9544 Questions

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How To Deal With White Coat Syndrome?

Brief Answer: Pharmacological therapy is not necessary. I advise you as follows: Detailed Answer: Hello! Thank you for your question on HCM! Regarding your concern I would like to explain that your symptoms seem to be caused by anxiety and a kind of fear when consulting with a doctor. This is a very known phenomena, which occurs in up to 40% of the persons. The episodes of high blood pressure occur exclusively during doctor appointments and are accompanied with fear and anxiety. White coat hypertension is a benign condition, and the organ damage from these episodes of high blood pressure has been evaluated in many studies to be non-significant ( just like in normal persons). I would first recommend you to perform an ambulatory 24 hours blood pressure Holter monitoring and routine blood tests, liver and renal function tests, to exclude other causes of high blood pressure. I would not recommend a pharmacological treatment for this disorder . Instead, I would advise you to modify your lifestyle: decrease your daily salt intake, reduce your weight, exercise regularly, avoid smoking, and correct blood glucose and lipid abnormalities if they are encountered in your check ups. Some tips to lower your anxiety when consulting with the doctor would be also helpful: - Psychotherapy -Try not to change your doctor -Avoid caffeine when going to the doctor - Go to the doctor accompanied by a family person or a friend. In addition I would recommend you to follow-up with ambulatory blood pressure monitoring every 6 months. Hope to have been helpful! Greetings! Dr. Iliri