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What Causes Spike In BP Reading At A Doctor's Office?

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Posted on Fri, 4 Apr 2014
Question: what would be your approach if one (me) had normal blood pressure readings outside a medical office yet had high readings when tested in such an office? The machine, used to measure outside the office,was confirmed to be accurate . It was used in the Dr. office when the bp was tested ( both the cuff and machine were high; in fact the machine was higher). My Dr. said as long as there are spikes in the office there will be spikes outside, thus meds are needed. Also I have received several med combo. with different potencies. None have brought the bp down at all. I have been doing this for 5 mos. I get it checked about 1/ we. Thank you
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Answered by Dr. Rakesh Karanwal (53 minutes later)
Brief Answer: You apparently have "White Coat Hypertension". Detailed Answer: Hi, Thanks for your query. Narration of your problem suggests that you most likely have "White Coat hypertension", which occurs when the blood pressure readings you have measured at your doctor's office are higher than they are when measured in other settings, such as your home. It's called white coat hypertension because the doctor/health care professional who measure your blood pressure usually wear white coats. It occurs due to a subconscious fear or apprehension because most of the people correlate doctor's clinic or a hospital with sickness or injury; or that, these are places where bad/unpleasant things happen. Hypertension is defined as persistently increased BP readings at any time of the day. The ideal way to differentiate actual hypertension from White Coat Syndrome is to measure your BP at home, AS SOON AS YOU WAKE UP, EVEN BEFORE YOU GET OUT BED (called Basal Blood Pressure). Hypertension is ruled out if the basal blood pressure is consistently within normal range, over several days. YOU WILL REQUIRE TREATMENT ONLY IF THE BASAL BLOOD PRESSURE READINGS, RECORDED DAILY, ARE PERSISTENTLY HIGH. Since White Coat hypertension is merely a fear response (with as much as 20% of the population having this syndrome), manifested in the form of a transient increase in BP, I DO NOT SUBSCRIBE TO THE VIEW OF YOUR DOCTOR PUTTING YOU ON ANTI-HYPERTENSION MEDICATIONS. This is despite the fact that some doctors think that white coat hypertension might signal that you're at risk of developing high blood pressure as a long-term condition. I would therefore suggest that you talk to your doctor about home monitoring of your condition. This can help determine if your high blood pressure only occurs in the doctor's office, or if it's a persistent condition that needs treatment. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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What Causes Spike In BP Reading At A Doctor's Office?

Brief Answer: You apparently have "White Coat Hypertension". Detailed Answer: Hi, Thanks for your query. Narration of your problem suggests that you most likely have "White Coat hypertension", which occurs when the blood pressure readings you have measured at your doctor's office are higher than they are when measured in other settings, such as your home. It's called white coat hypertension because the doctor/health care professional who measure your blood pressure usually wear white coats. It occurs due to a subconscious fear or apprehension because most of the people correlate doctor's clinic or a hospital with sickness or injury; or that, these are places where bad/unpleasant things happen. Hypertension is defined as persistently increased BP readings at any time of the day. The ideal way to differentiate actual hypertension from White Coat Syndrome is to measure your BP at home, AS SOON AS YOU WAKE UP, EVEN BEFORE YOU GET OUT BED (called Basal Blood Pressure). Hypertension is ruled out if the basal blood pressure is consistently within normal range, over several days. YOU WILL REQUIRE TREATMENT ONLY IF THE BASAL BLOOD PRESSURE READINGS, RECORDED DAILY, ARE PERSISTENTLY HIGH. Since White Coat hypertension is merely a fear response (with as much as 20% of the population having this syndrome), manifested in the form of a transient increase in BP, I DO NOT SUBSCRIBE TO THE VIEW OF YOUR DOCTOR PUTTING YOU ON ANTI-HYPERTENSION MEDICATIONS. This is despite the fact that some doctors think that white coat hypertension might signal that you're at risk of developing high blood pressure as a long-term condition. I would therefore suggest that you talk to your doctor about home monitoring of your condition. This can help determine if your high blood pressure only occurs in the doctor's office, or if it's a persistent condition that needs treatment. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal