White Coat Syndrome: How To Manage Increased Heart Rate At The Doctor's

If your heartbeat quickens and your breaths get shorter every time you visit the doctor, you're in good company. An estimated 20% of people with borderline blood pressure levels suffer from what some people call "white coat syndrome." Named for the coats healthcare providers often wear, white coat syndrome causes blood pressure levels to spike during physician visits.

What Are the Effects Of White Coat Syndrome?

White coat syndrome is also called white coat hypertension because of its effects on blood pressure levels (hypertension is the medical term for elevated blood pressure). Normal blood pressure levels hover around 120/80 millimeters of mercury (mmHg). When those levels rise to 140/90 mmHg (or higher), that's high blood pressure.

If you get nervous during physician visits, it's not uncommon for blood pressure levels to climb. The trouble is, doctors measure blood pressure to get a sense of what's "normal" for you, not a short-lived elevation due to temporary stress and anxiety.

What Are Some Ways Around White Coat Syndrome?

With white coat syndrome, the goal is to address the underlying reasons your blood pressure is rising. That way, over time, your doctor will be able to get a more accurate assessment of your "true" blood pressure during office visits. A few strategies that can help:

1. Take a deep breath. Taking slow, deep breaths signals your brain that you're safe. Before you get your blood pressure checked, sit down, quiet your mind, and breathe deeply for a few minutes.
2. Come prepared. Come with a list of questions to address and a mental plan for the appointment. The more in control you feel during visits, the better equipped you'll be to control your breathing and remain calm.
3. Bring support. Studies show that just holding a loved one's hand can reduce blood pressure levels and help you feel safe during difficult moments.
4. Develop a partnership with your provider. Visit your provider at least once each year or more often if you have a chronic health condition. The more comfortable and familiar you are with your doctor, the less likely you'll be anxious during visits.
5. Monitor blood pressure at home. There are a variety of blood pressure devices and monitors designed for home use. To ensure the product you purchased produces reliable readings, take it to the doctor's office with you. If your doctor's cuff produces the same value as your home device, you're in business. You can use the monitor at home and know you’re getting accurate readings.

Keep in mind that a variety of factors — from whether you've had caffeine to how well you slept — can influence your blood pressure levels. But if your measurement is well above 120 over 80 when you visit the doctor, that's not white coat syndrome. It's high blood pressure.

A Guide To Home Blood Pressure Monitoring

As with any medical device, home blood pressure monitors require you to take certain steps to get an accurate measurement. Once you know the device's readings fall in line with the one produced at your doctor's office, follow the same sequence every day to get the best reading:

• Make it part of your morning routine. Take your blood pressure in the morning before you've had coffee, tea or breakfast. Foods and beverages can cause blood pressure levels to rise temporarily.
• Relax. Before you measure your blood pressure, take a few deep breaths, sit quietly by yourself, and make sure your legs and ankles are not crossed.
• Keep your arm at heart level. Make sure you're seated in an upright position and place the blood pressure cuff directly on the skin at the level of your heart.
• Follow directions. This may seem obvious, but different blood pressure monitors operate differently. It's important to read the directions for the device you purchased and operate it accordingly.

Doctors love to see data, so make sure to keep a log of your daily blood pressure readings. Over time, you may begin to notice patterns related to when it dips or spikes. Unfortunately, consistently high blood pressure increases the risk of stroke, heart disease and kidney failure. And research suggests that white coat syndrome increases the risk of developing true hypertension.

The good news: There are plenty of things you can do to keep blood pressure levels in check, including:

• Eat a healthy, low-sodium diet.
• Exercise regularly.
• Get sufficient sleep.
• Stop smoking.
• Talk to your doctor about whether medication is necessary.

To find a doctor at Henry Ford, visit henryford.com or call 1-800-436-7936.

Dr. Kimberlydawn Wisdom is the Senior Vice President of Community Health & Equity and Chief Wellness & Diversity Officer for Henry Ford Health. Read more about Dr. Wisdom.