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White-Coat Hypertension

In times of stress, blood pressure goes up. That's understandable — and, sometimes, necessary. It boosts your energy, enabling you to function at your highest level.

Sometimes, however, this stress reaction can be likened to a case of stage fright, such as when blood pressure readings taken during a doctor's appointment are high and readings taken elsewhere are normal.

Simple stage fright or a warning?

A recent study describes how this phenomenon, known as white-coat hypertension and previously thought to be harmless, is related to a significantly greater risk of developing sustained high blood pressure within 10 years, says Shaila Pai-Verma, MD, an internist at Rush University Medical Center.

If you have white-coat hypertension, it's important to watch your blood pressure closely because serious health problems, including heart attack and stroke, are more likely with sustained high blood pressure. Here are three steps to help you keep track of your blood pressure.

  1. Select the right blood pressure monitor. Different types are available. Pai-Verma recommends getting one for the upper arm, as opposed to a wrist monitor, which may not give an accurate reading. Typically a pharmacist can help you select a good monitor and explain how to use it.
  2. Take regular readings. Use your monitor to take your blood pressure at least twice a week. To get accurate readings, avoid excessive alcohol or caffeine and don't smoke or take medicines that can raise blood pressure, such as decongestants, for about four hours before your home checks, advises Pai-Verma. Keep a record of your results, and bring it to your next doctor's appointment, along with your monitor. Your doctor can check the monitor's accuracy by ensuring readings you get on it while at the office match those that the doctor gets with his or her monitor.
  3. Follow your doctor's advice. If your blood pressure readings stay below 140/90 mm Hg, you can usually continue with home monitoring and regular doctor visits, Pai-Verma says. If readings hit 140/90 mm Hg or higher, you may need to take medication and make lifestyle changes, such as eating healthfully, exercising and losing weight. Seeing your doctor as directed is important to ensure you get the right medications and dosages.

Shaila Pai-Verma, MD, practices with Associates in Internal Medicine. Her areas of interest include hypertension, preventive medicine and diabetes.


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