White Coat Syndrome: Why Is Blood Pressure Higher at the Doctor’s Office?

When I hear “white coat syndrome,” I think of my husband. He takes his blood pressure at home almost every day and writes it down. He takes blood pressure medicine, and most of the time his numbers at home are right where they should be.

Then he goes to the doctor and, sure enough, it’s high – high enough that they come back for a second and sometimes a third try – it may go down a bit, but it usually still doesn’t reflect his numbers at home.

He started checking it before he leaves for an appointment and it can look perfectly good at home that morning and still be high by the time he gets to the doctor’s office. Now he brings his monitor and his list of readings so his doctor can see what he’s been getting at home.

What Is White Coat Syndrome?

“White coat syndrome” is what people often call it when their blood pressure runs higher at the doctor’s office than it does at home. Just being in a medical setting can make some people tense up. And once you’ve had a few high readings at the office, I can see how you’d start wondering what the cuff is going to say before it even squeezes your arm.

Why Track Your Blood Pressure at Home?

The list my husband keeps of his blood pressure readings gives his doctor a better idea of what’s usual for him. Bringing the monitor along also gives her a chance to check the cuff fit, watch how he uses it, and see how its readings compare with the office equipment.

I’m glad he writes his numbers down, because it would be easy to get to the appointment and just say, “It’s usually lower at home.” With his list right there, he can show her what “usually” looks like.

How to Take Your Blood Pressure at Home

• Use an upper arm cuff that fits. Put it on your bare arm and rest your arm on a table so the cuff is about level with your heart.
• Give yourself five quiet minutes before taking your blood pressure. Sit with your back supported and both feet flat on the floor. Stay quiet while the cuff is taking the reading.
• Take two readings a minute apart. Write both down, along with the date and time, so you have something to look back at.
• Wait 30 minutes after caffeine, smoking, or exercise. Those can affect the reading you get.

Everyday Habits That Can Help With Blood Pressure

Taking your blood pressure at home helps you see what your numbers are doing. These everyday habits can help manage blood pressure over time and fit alongside any blood pressure medicine you take.

Take Regular Walks

A short walk after lunch or dinner is an easy place to start. Pick a time that fits your day so it’s easier to make it a regular thing.

Check the Sodium on Foods You Buy Often

Next time you buy soup, bread, or pasta sauce, compare the sodium on a couple of brands using the same serving size. You might find a lower-sodium version of something you already like.

Add More Fruits, Vegetables, and Whole Grains

Start with meals you already make. Add berries to your oatmeal, toss some extra vegetables into your soup, or try brown rice with a dinner you usually serve with white rice.

I’m sure my husband will hear “let’s take that one more time” at the doctor’s office. At least when he says his blood pressure was lower at home, he can show his doctor exactly what it was.

American Heart Association: Guide to Home Blood Pressure Monitoring