Is White Coat Hypertension Real?

Does your blood pressure spike at the doctor’s office? If so, you’re not alone. Many people have a condition called white coat hypertension, which means their blood pressure goes up whenever they’re in a medical setting.

Find out more about this condition and what you can do to help keep your blood pressure in a healthy range.

White Coat Hypertension: Fact or Fiction?

What is blood pressure?

Your blood pressure is the force that your blood exerts on your artery walls as your heart beats. A blood pressure reading includes two numbers:

  • Your systolic pressure, or the force of blood against your artery walls when your heart contracts to pump out blood. This is the top number in your reading, for example, 120.
  • Your diastolic pressure, or the force of your blood against your artery walls when your heart rests between beats. This is the bottom number in your reading, for example, 80.

While blood pressure can change throughout the day, in general:

  • If your blood pressure is 120/80 mmHg or lower most of the time, it is considered to be normal
  • If your blood pressure is higher than 120/80 mmHg, but lower than 140/90 mmHg most of the time, it is considered pre-hypertension
  • If your blood pressure is 140/90 mmHg or higher most of the time, it is considered high blood pressure or hypertension

What is white coat hypertension?

White coat hypertension, also called white coat syndrome, is a real condition that happens when you have high blood pressure readings at your doctor’s office, but normal readings at home.

“Because high blood pressure is a major risk factor for heart disease and stroke, it’s very important to keep an eye on it and understand how a high reading at your doctor’s office might mean that you’re at risk,” said Matthew Muldoon, MD, director of the UPMC Heart and Vascular Institute’s Hypertension Program.

Doctor visits can make some people nervous or anxious, which may raise their blood pressure.

According to Dr. Muldoon, this can be a sign that your blood pressure may be high at other stressful times, which can raise your risk for heart disease. To lower your risk, it’s best to keep your blood pressure in a healthy range as often as you can.

How do I know if I have high blood pressure?

High blood pressure doesn’t usually have symptoms, so it’s important to have your blood pressure checked by your doctor. Most adults should have a blood pressure reading by a medical professional at least every two years, but your doctor may recommend them more often based on your age, family history, and other risk factors like smoking.

If you have several high blood pressure readings at your doctor’s office, he or she might recommend the following to determine whether you need treatment:

  • Home blood pressure monitoring, in which you track your blood pressure by taking readings several times a day, then recording the readings for your doctor to review
  • Ambulatory blood pressure monitoring, in which you wear a small blood pressure monitor that takes readings at preset times for a 24-hour period, including when you sleep, and track your activities

Can high blood pressure be treated?

“Millions of people have high blood pressure, but the good news is that it’s treatable,” said Dr. Muldoon. “Treatments vary based on your medical history, risk factors, and lifestyle.”

The UPMC Heart and Vascular Institute’s Hypertension Program offers comprehensive treatment for people with high blood pressure. To learn more, visit the UPMC Heart and Vascular Institute or call 1-855-UPMC-HVI (876-2484).

For many people, initial treatment involves lifestyle changes that can include:

If lifestyle changes aren’t enough to keep your blood pressure in a healthy range, your doctor may recommend medicines to help. Once you begin taking blood pressure medicine, do not stop until first talking to your doctor.