Tag Archives: hypertension

Is White Coat Hypertension Causing You Undue Worry?

Over one third of Americans suffer hypertension: the silent killer. We took a look at masked hypertension (when someone experiences higher ambulatory blood pressure readings than those in the doctor’s office) in our last post, and up next, we’d like to check out its opposite phenomena: white coat hypertension.

White Coat Syndrome

White coat syndrome (or effect) refers to a fairly common type of nervousness or anxiety people experience when visiting doctors. The term ‘white coat’ derives from the fact that medical doctors traditionally wore white jackets. This type of anxiety can spur from a distrust of doctors based on bad past experiences, a worry of receiving the wrong treatment, or perhaps from a fear of hearing bad news from a doctor. It is common to feel stressed about visiting the doctor, especially if you are waiting for results or undergoing an examination. It is estimated that nearly 20% of Americans suffer from some degree of white coat syndrome.

What is White Coat Hypertension?

White coat hypertension is an offshoot of white coat syndrome. It occurs when a person is anxious to have their blood pressure taken or be examined by a physician, so their blood pressure numbers present much higher in the doctor’s office than if measured at home. Generally, a person’s blood pressure should only vary by a few millimeters of mercury (mmHg) when taken at the doctor’s office versus at another location. This means no more of a variance than 10mmHg for the top number (systolic) and 5mmHg for the bottom number (diastolic). People with white coat hypertension may have a large fluctuation in their readings at a doctor’s office and relatively normal blood pressure when measured throughout the day at home.

Could White Coat Hypertension Lead to A Misdiagnosis?

While it is possible that a doctor may misdiagnose a person experiencing white coat hypertension as having actual hypertension, this would likely be a rare occurrence as most physicians would double check with ambulatory readings (using a portable blood pressure monitor at home). If a doctor suspects high blood pressure due to several in-office readings, they often suggest home monitoring for a 24-hour period or longer to cross check with their own readings to ensure the diagnosis is accurate before proceeding with treatment. If your doctor does not suggest home monitoring before trying to prescribe blood pressure treatment, you should certainly request it.

What Can be Done To Prevent White Coat Hypertension?

If you know you are experiencing this phenomenon, it is important to try to de-stress before entering a doctor’s office. You should also let your doctor know that your home readings have been in the normal range so that no unnecessary treatment ensues. If you are having trouble bringing your anxiety level down before visiting a doctor, take a look at some of our stress busters. People with more severe white coat syndrome may need to seek psychological therapy to figure out the root of their fear of medical environments and work toward dealing with it.

Can White Coat Hypertension Turn into Hypertension?

Yes. While it is common for everyone’s blood pressure to fluctuate during the run of a day, it is possible that someone who experiences significant stress-related blood pressure spikes may go on to develop high blood pressure. For this reason, you will likely continue to be monitored by your doctor (and at home) to ensure your blood pressure is in check in the future as well.

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Could You Have Masked Hypertension?

Approximately a third of American adults suffer from hypertension (a whopping 75 million people). Some may not even be aware they have the condition. Just because your blood pressure readings are okay at the doctor’s office doesn’t mean you’re in the clear. There are two phenomena that result in inaccurate blood pressure readings at the doctor’s office: one is called ‘masked hypertension’, and its opposite is called ‘white coat hypertension’. Today we’re going to investigate masked hypertension.

What is Masked Hypertension?

Masked hypertension is a phenomenon whereby a person’s blood pressure measures in the healthy zone when they are visiting a doctor, but readings are much higher when they self-measure at home or at another location. This may occur because some people find a doctor’s office to be a calming environment, whereas their home life may be quite hectic or busy which may affect their blood pressure. Masked hypertension may also be a result of a person’s blood pressure spiking when they partake in activities such as drinking or smoking on a regular basis.

How Common is Masked Hypertension?

According to Doctor Deepak Bhatt, MPH, editor of the Harvard University Heart Health letter, the only reason we know this condition even exists is because of several studies that required participants to gather ambulatory blood pressure readings as well as some in a doctor’s office. In some of the studies, up to 40% of participants experienced higher blood pressure in everyday life than in the doctor’s office. Unfortunately, we have no way of knowing the true number of people affected by masked hypertension because if a person’s readings are fine in the office, a doctor commonly won’t request they check them at home.

What to do About Masked Hypertension?

Dr. Deepak suggests that because high blood pressure is such a prevalent problem in America, those middle-aged or older should invest in a home monitor to occasionally check their numbers to ensure their readings are healthy across the board or to alert them if the readings differ. Blood pressure is a silent killer if left undetected and unmanaged, so it is important to know your true numbers.

Stay tuned next time for the opposite phenomenon known as white coat hypertension. Thanks for visiting DocChat!


The High Risks Of Hypertension


Blood Pressure (BP) is calculated by measuring the force of blood coursing your arteries as your heart is pumping, called systolic pressure, over your diastolic pressure, the force of blood flow through the arteries while your heart is relaxed and refilling. High blood pressure, also known as hypertension, consists of a chronic BP reading of 140/90 or higher (www.heart.org). According to the American Heart Association, over 80 million Americans have been diagnosed with high blood pressure.

Devil May Care

Everyone knows that high blood pressure is problematic, but the complications are more dangerous than we may think. Unfortunately, not every one properly heeds their doctor’s warnings of high blood pressure. Often when a person is diagnosed, they just stick the information on the dusty top shelf of their mind, and continue on with everyday business. However, nonchalance certainly is not the attitude any of us should be taking toward Hypertension.

The Silent Killer

Hypertension has been deemed ‘the silent killer’ for a reason. Most people have no symptoms as their pressure gradually climbs to unhealthy heights, putting the body in danger. According to Kathy Berra, clinical director of the Stanford Heart Network at the Stanford University School of Medicine, “Many people assume you will get a headache or some other kind of signal when blood pressure is high, unfortunately, this is rarely the case. Often, the first sign of unknown or untreated high blood pressure is a stroke, a heart attack, or kidney disease.” This is a scary notion to say the least.

Are You At Risk?

Even though hypertension is an intruder of the silent variety, there are some risk factors that can let you know if you are in danger of developing the condition. The World Heart Federation states that “Lifestyle and genealogy are significant contributors to high blood pressure. One can inherit it from parents and grandparents, but diet, tobacco use, stress levels, and lack of exercise are the leading causes.”

Comorbid Culprits

Aside from the disease itself, unchecked chronically elevated BP levels can also lead to other conditions such as kidney damage and failure, transient ischemic attacks (mini stokes), or even full blown strokes. Hypertension can also lead to potentially fatal heart problems including atherosclerosis (hardening of the arteries due to fatty buildup), and congestive heart failure. Also, the World Heart Association has established a strong link between chronically elevated blood pressure and diabetes. These are just a few of the many comorbid conditions that go hand in hand with high blood pressure.

What Can You Do?

There are many things we can do to prevent hypertension, or help reverse the condition. According to the University of Maryland Medical Center, some of the things you can do to manage your blood pressure include maintaining a healthy diet and weight, quitting smoking, keeping alcohol consumption at a low-to-moderate level, exercising regularly, as well as keeping stress levels under control.

The National Heart, Lung and Blood Institute recommends a nutritive system developed by their research teams called the Dietary Approaches to Stop Hypertension (or the DASH eating plan), to help prevent or reverse high blood pressure. This diet centers mainly around vegetables, fruit, certain dairy products, whole grains, fish, poultry and seeds or nuts. It also advises limiting intake of sugar, red meat and excess sodium.

Check Your Numbers

Every adult should have their blood pressure checked at their next routine check-up to ensure there are no red flags. By checking your BP every now and then, you could avoid years of silent damage. You can check your blood pressure for free at most pharmacies, or you can buy a home blood pressure monitor. Stanford University’s Kathy Berra maintains that if you suspect, or have been told by your doctor that you have issues with blood pressure, the best course of action is to start checking and recording it yourself regularly.


The World Heart Federation: http://www.world-heart-federation.org/

The University of Maryland Medical Center: https://umm.edu/health/medical/reports/articles/high-blood-pressure

The National Heart, Lung and Blood Institute: https://www.nlm.nih.gov/medlineplus/dashdiet.html

The American Heart Association: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp

Bewell @ Stanford University: https://bewell.stanford.edu/blood-pressure

Obesity – Understanding the Risks


Obesity is a common problem that involves accumulation of undue amount of fat in your body. If you are extremely obese, it means that you are at risk of health complications. You should take proactive measures to steer clear of obesity to avoid these potential health problems.

Here are the risks associated with being obese:

Heart Diseases

Obesity leads to increase in your body mass index (BMI), which in turn makes you more susceptible to coronary heart disease. The condition involves the buildup of plaque – a waxy material- in your coronary arteries that can make the arteries thin or completely block them, and decrease the flow of blood to your heart. The outcome can be chest pain or a heart attack. When the condition becomes serious, it can even cause a heart failure.


Obesity can result in hypertension- a condition whereby the force applied by the blood against the walls of your arteries increases. If your blood pressure increases and remains constantly high, it can cause damages to your body. The more obese you are, the more the chance for hypertension.


If you are overweight or obese, you are at risk of stroke because obesity generates plaque in your arteries, and there are chances that a portion of the plaque can break up, growing a blood clot in one of your arteries. And, if the clot is created somewhere near your brain, it has the potential to shut down blood and oxygen supply to your brain. When blood and oxygen supply to the brain stops, the risk of experiencing a stock increase.


Diabetes is a health condition that involves increase in your blood sugar level. Under normal circumstances, the human body converts foods into glucose and then transports them to the cells, which use insulin to convert the glucose into energy. However, when you are suffering from type 2 diabetes, your body cells can malfunction when it comes to using insulin. Obese people are more at risk of type 2 diabetes, which is among the major causes of deaths, kidney diseases, strokes, heart diseases and blindness.


Being obese and overweight can also increase your risk for Osteoarthritis, which is a common condition that involves wear and tear of your joints, including hip joints, knee joints and your lower back. Rise in weight increases the pressure on the tissues that protects your joints, leading to wear and tear of the joints. This condition can cause unbearable pain.

It is important to stay healthy and lose weight. The best way is to have a healthy diet and workout regularly. However, obesity is not merely being overweight, it is classified as a disease and hence medical intervention may be necessary. If you’re overweight or feel you need to lose weight, get in touch with us today and let us suggest you the best tools to stay fit.