White Coat Syndrome

Doctor in a white coat -- Don't Be nervous!

What is White Coat Syndrome

White coat syndrome, also known as white coat hypertension, is a common phenomenon where a person's blood pressure rises when they are in a medical setting or when they are being examined by a healthcare provider, such as a doctor or a nurse. This temporary increase in blood pressure can lead to a misdiagnosis of hypertension, which is a chronic condition characterized by high blood pressure.

The prevalence of white coat hypertension is estimated to be around 10-20% of the general population. This means that a significant number of people may experience an increase in blood pressure only in a medical setting, but have normal blood pressure readings outside of such settings.

In some cases, the increase in blood pressure caused by White Coat Syndrome can be significant, with readings elevated by 20 mm Hg or more for systolic blood pressure and 10 mm Hg or more for diastolic blood pressure. However, in other cases, the increase may be less pronounced.

The name "white coat" comes from the fact that medical professionals often wear white coats, and the syndrome is typically observed in medical settings. The increase in blood pressure is thought to be caused by the person's anxiety or nervousness about being in a medical environment or being examined by a healthcare provider.

Symptoms of White Coat Syndrome

The symptoms of white coat syndrome are often similar to those of hypertension, which can include headaches, dizziness, and chest pain. Patients can also present with anxiety symptoms like sweating, clammy hands, fidgety, etc. However, unlike hypertension, the symptoms of white coat syndrome are temporary and typically only occur in medical settings.

Diagnosing White Coat Syndrome

To diagnose white coat syndrome, doctors may use a blood pressure monitor that the person can wear at home, outside of a medical setting, to see if their blood pressure returns to normal levels. If the person's blood pressure is consistently high even when they are not in a medical setting, they may be diagnosed with hypertension and treated accordingly.

Causes of White Coat Syndrome

The exact causes of white coat syndrome are not fully understood, but it is thought to be caused by the person's anxiety or nervousness about being in a medical environment or being examined by a healthcare provider. This can be especially true for people who have had negative experiences with medical procedures or who have a fear of needles or medical procedures. This anxiety can trigger the release of stress hormones, such as adrenaline and cortisol, which can cause the blood vessels to constrict and the heart to beat faster, resulting in an increase in blood pressure.

Another possibility is that people may be more aware of their blood pressure readings in a medical setting, which can cause them to feel more anxious or stressed than they would be otherwise. Additionally, medical professionals may take multiple readings in a short period of time, which can further increase anxiety and lead to elevated readings.

Treatment for White Coat Syndrome

Treatment for white coat syndrome may not be necessary, as it is a temporary condition that typically does not cause any long-term health problems. However, if the person's blood pressure remains high even when they are not in a medical setting, they may be diagnosed with hypertension and treated accordingly.

If the person has mild symptoms of white coat syndrome, such as occasional anxiety or nervousness in medical settings, they may benefit from relaxation techniques, such as deep breathing exercises or meditation, to help them manage their symptoms.

Tips to Beat White Coat Syndrome

Preventing white coat syndrome may be difficult, as it is a natural response to being in a medical environment or being examined by a healthcare provider. However, there are some steps that can be taken to reduce the symptoms of white coat syndrome, such as:

  • Informing the healthcare provider about any previous experiences of anxiety or nervousness in medical settings. The provider may leave the room and have you sit in silence to calm down for five minutes before reading.

  • Relaxation techniques, such as deep breathing exercises or meditation, to help manage anxiety.

  • Monitoring blood pressure at home, outside of a medical setting, to help differentiate between white coat syndrome and hypertension.