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What is White Coat Syndrome?

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  • Written By: Tara Barnett
  • Edited By: Melissa Wiley
  • Last Modified Date: 13 November 2016
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White coat syndrome, sometimes called white coat hypertension, is a situation in which a person experiences high blood pressure at a doctor's office while blood pressure is being taken but not when blood pressure is taken at home. The syndrome is almost certainly caused by the anxiety of visiting a doctor's office. Blood pressure may also be high in other situations that cause stress, but the syndrome is characterized by it always being high when visiting a doctor. While this condition is less serious than constant hypertension, it is still more dangerous than having a healthy blood pressure.

The term white coat syndrome refers to the traditional white coat worn by doctors. Many doctors no longer wear a white coat, particularly in small practices. Even a doctor who is not wearing a white coat may still cause anxiety in patients and may therefore cause white coat syndrome. The anxiety experienced when visiting a doctor is almost always related to the clinical situation rather than the coat, so white coat syndrome can be experienced even when a nurse takes the patient's blood pressure.

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Usually, white coat syndrome is differentiated from consistent hypertension by taking several blood pressure readings outside the clinical setting. One very effective way to diagnose this particular type of hypertension is to have the patient wear a special device that monitors blood pressure over a longer period of time, often over a day. Usually, anxiety due to the testing or the doctor will fade over the day, and eventually comparative readings can be taken.

Although a person who experiences white coat syndrome should be careful to maintain an ideal weight and refrain from eating too much sodium, rigorous treatment is usually not required. Sometimes this disorder may develop into a constantly high blood pressure, particularly when a person is consistently under stress. It is almost certainly not necessary to treat this syndrome with medication, as over treatment may result in hypotension. For this reason, making the correct diagnosis is very important when treating white coat syndrome.

When attempting to avoid experiencing hypertension in stressful situations like visits to the doctor, deep breathing may be effective. Although most people do not experience increased heart rate in conjunction with white coat syndrome, being mindful of one's body can sometimes help reduce anxiety in general. It is often true that people who are anxious in clinical settings are not merely afraid of doctors, but experience more general anxiety. Reducing stress overall not only reduces the effects of this disorder but also improves health overall.

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croydon
Post 3

@bythewell - I wonder if this gets mitigated by the fact that people have to wait so long in order to see the doctor. I mean, whenever I have an appointment, I always end up waiting for what seems like an extra hour, which seems like a pretty good cure for being nervous.

Also, it's usually the nurse who takes the blood pressure in the triage bit at the beginning. But maybe that's just my doctor's office and doesn't apply to all of them.

bythewell
Post 2

I didn't realize there was a term for this. I often wondered if this was happening whenever I went to the doctor. The band they put on you to measure your blood pressure is so tight it always makes me feel really nervous and I don't like going to the doctor in general.

I haven't ever had any very high blood pressure readings though, so I guess it's not that big of a deal. I could definitely see why it might be a problem for some people though.

clintflint
Post 1

One of the most beautiful and sad depictions of this I've ever seen was on the film Amelie, where the little girl had a doctor for a father.

She was never hugged or held by her parents and they said that he only touched her once a year in order to give her a physical.

The fact that he was holding her made her little heart beat faster with joy and that gave him the false impression that she had a heart condition, which made him treat her even more like an invalid in order to reduce her blood pressure.

It's not completely the same, as she wasn't afraid, but excited, but it had the same consequences.

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