CHECK-UP:Blood pressure may rise due to anxiety experienced while in a clinical setting, writes Marion Kerr.
When I get my blood pressure taken by the practice nurse it is usually normal. But every time my GP takes it, it is raised. He says it's "white coat syndrome". What is this?
Blood exerts pressure against the walls of the arteries as the heart pumps it through the body. Through a complex system which involves the brain, kidneys and nerves, the body regulates blood pressure by releasing certain hormones into the bloodstream. Other elements that influence blood pressure include the strength of the heart and its pumping ability.
Blood pressure is measured in millimetres of mercury (mm Hg) using two values; systolic and diastolic. Systolic is the maximum pressure reached when the heart contracts - normal systolic pressure ranges from 100 to 135mm Hg. Diastolic pressure measures minimum pressure, when the heart relaxes between beats.
A normal diastolic pressure ranges between 60 and 80mm Hg. However, blood pressure can be influenced by other factors, including exercise and emotions such as stress. White coat syndrome or white coat hypertension are terms used to describe blood pressure that rises in response to the anxiety experienced by some people when visiting a doctor or while in a clinical setting.
Is there any test to confirm white coat syndrome?
As blood pressure fluctuates over the day depending on what we are doing and how we are feeling, the only way to prove a diagnosis of white coat syndrome is to have a 24-hour ambulatory blood pressure test.
This involves the wearing of a monitor which measures blood pressure at half-hourly intervals over a 24-hour period. The results of the test allow the doctor to see when and by how much your blood pressure fluctuates over the day.
If I have to take blood pressure tablets, how long will I have to stay on them?
If hypertension is diagnosed, medication will help return blood pressure to within normal limits. However, this does not mean that the problem is cured; only that blood pressure is controlled.
It is important not to stop medication without medical advice as without it serious problems may develop. Symptoms of poorly controlled hypertension include headaches, dizziness, fainting, numbness and weakness.
It can also cause chest pain, palpitations and breathlessness. Uncontrolled hypertension can ultimately lead to serious illness such as heart attack, kidney damage and stroke. Anyone taking anti-hypertensive medication should talk to their doctor before stopping the tablets.
White coat syndrome
White coat syndrome or white coat hypertension are terms used to describe blood pressure that rises in response to the anxiety experienced by some people when visiting a doctor or while in a clinical setting.