Blood Pressure and White Coat Syndrome

[LovelyLadyLux]

I watched an interesting news clip on Blood Pressure. It has apparently been studied that people's blood pressure goes UP when it is taken IN OFFICE by a med tech wearing a WHITE medical coat. Seems we're nervous about going to the doctor's office and then we get more anxious when we see the white coat coming which results in artificially high blood pressure readings. Course these high readings lead to medication being dispensed that is perhaps unnecessary.

The proposal is that NOW in order to get accurate blood pressure readings the person is fitted with a portable machine they can wear for a 24 hour period that takes their pressure. This will apparently give more accurate results and will hopefully cut down on the amount of bp meds being prescribed.

Seems an interesting theory. My own bp is typically quite low so am not a candidate for medication for it but personally it seems to me to be another "we can do it all for you" type measure. I wonder if people really do get upset being IN a doctors office and when they see somebody wearing a white coat?

I can believe that a child might get upset but I really am not thinking that adults would. But then children don't really get high blood pressure..........thoughts?

[Jayway]

Speak for yourself, LLL. I have low blood pressure, mocked at the clinic when I call in for a bit of oxygen=zombie ! But, when I need to see the doctor for sure my bp GOES UP. (which is why I dont go very often)

[Horus]

In the pre-op tests prior to having a cataract removed my BP was so high they said they may need to cancel the operation. I asked the nurse to wait a while and to just chat away normally then take the reading when I was not aware she was going to do it. She agreed to do this and took it after about another 10 minutes, the result was a perfectly normal reading. I am not afraid of hospitals although I don’t particularly like them, but I definitely suffer from ‘White Coat Syndrome’.

[Grandad]

We sometimes get a letter from the docs asking us to go into the surgery and do a blood pressure reading with the machine which is in the reception area. We won't do that because I will not accept one reading as being of any real value. Instead, I take 8 or 10 readings over 3 days and present them as a chart. Our doc loves them and agrees that they are far more meaningful than an isolated reading.

And yes, we both suffer white coat syndrome particularly Mrs G.

[Mad Dilys]

Me too! A few years ago I wore a monitor for 24 hours. Just last week I had my BP taken at the hospital and saw the nurse grimace. I asked her what was up and she turned the display round which showed 180/110. As soon as I mentioned WCS she marked the top of my record card.

I'm not conscious of being apprehensive, but I have had my BP taken 7 times with several different machines by one doctor who didn't believe me at first.

[LovelyLadyLux]

WOW - I honestly thought this clip was a bit bogus but you have all convinced me! I'd never ever heard about it before and thought it a rather fanciful thing the doctors are doing. I could understand a child getting upset when they see a white coat especially if they've had medical issues that have been painful but I never ever thought an adult would react to having their blood pressure taken.

My bp is usually something like 88/60 or in the low 90ies over 60ies or 70ies. It is a good day if I crack 100. Sometimes, and I kid you not, the doctors have asked me to get up and walk around so they can get a reading......!!! Although I'm jesting about my low blood pressure there is more danger for a person with low bp as the doctors don't have as much ability to jack UP your pressure safely whilst there are lots of medications to bring it down.

I think what Grandad is doing is the most sensible IF bp is an issue and since white coat syndrome is really REAL. Take your own blood pressure over several days and then bring it into the doctor's office when you go. They'd probably be really happy with that and it would also give them readings over time.

[Robbo70]

When I had pains in my chest I was sent off for tests and the first one was blood pressure tests. It was sky high...as I pointed out trying to find a parking space and not be late for my damned appointment was probably the cause Sure enough, we did all the other tests first and it was fine.

[Horus]

LLL,as you say a low BP can also be a bad sign. Mrs H would always show up a low reading and at the time I used to think that was a good thing. After she passed so suddenly, the cause was given as not a heart attack, but rather a lack of Oxygen to her heart.

[LovelyLadyLux]

@H - did Mrs H get light headed if she had her head down and then came up suddenly too? I get that as there just isn't sufficient pressure going.

I've had surgeries and it has never been a concern - or, at least, the doctor have never verbalized a concern to me but one did explain once that because I have low blood pressure IF something was to happen to me and they had to inject to raise my bp UP the meds they have to do that are not as reliable as the ones used to bring bp down.

Hopefully now, as this seems a very valid syndrome, all the doctors will be taking your bp last and or recognizing the high reading might be temporary and not a true sign that you're suffering from high blood pressure. (I honestly thought it a fake story when I first came across it too!)

[Horus]

LLL, from what I can understand her heart just 'gave up' basically from a lack of Oxygen.

[LovelyLadyLux]

Hmmmm - I'm back to the doctor on the 12th Nov and now that you've piqued my interest I'm going to ask about my heart and low blood pressure. Wonder if I can do anything to raise it up? Never much really thought about it....

I'm also wondering IF my low bp rises when I see the white coat of a doctor? OMG - IF my bp comes UP to LOW wonder what my bp really is? Maybe I'm already dead!

[LovelyLadyLux]

@Robbo - what happened with your chest pains? Are they now managed with meds? Did they go away?

(HOPE you're OK!)

[Grandad]

I have just checked a chart that I did 2 years ago when my doc was reviewing my meds. I did an hourly reading over two days. The highest and lowest cystolics were 178 and 89, with all points in between. Not that averages are much use, the average over the two days was 133, OK for someone around 80 yoa.

So, the only reason I post this is to illustrate the pointless taking of one reading and making some judgement on it......

[Robbo70]

@Robbo - what happened with your chest pains? Are they now managed with meds? Did they go away?

(HOPE you're OK!)

It turns out its my gall bladder The pains can come anywhere in the chest, shoulders and neck apparently. Back to the boring meals of chicken and rice and cut out the spicy stuff. I had to stop drinking grapefruit juice and other highly acidic drinks too. Vodka and blackberry juice seems tolerable though thank god

[LovelyLadyLux]

Ahh the old gall bladder attack.........I had those and remember them well and the pain does go up and float around your chest. My gall bladder is long gone. Seems on my dad's side of the family everybody loses their gall bladder when they pass early 30ies - almost like some ridiculous right of passage!

Now having a gall bladder removed is day surgery. Mine was taken out in the time of major incisions followed by weeks of rest.

My attacks always followed eating pork chops.

Over the years though I've modified my diet and changed away from the style of meals served by my parents which were pretty much mashed potatoes, canned pea type veggies and meat (extremely well cooked).

Hope there are now no attacks Robbo. Are there plans for removal or are they expecting you to live with it and manage through diet?

[Robbo70]

I was given omroprozole and told to change my diet and see if that managed it. I was also given some wonderful painkillers for the short term. It appears that less sugar and a lot less fat in my diet has it all running peacefully now. I confess to topping up my omroprozole in Luxor last month so I don't have to pay £8.30 for a top up I think its a case of wait and see for now. If it starts to flare up regularly I will just get it whipped out when the kennels are quiet.

[LovelyLadyLux]

In my family almost every girl cousin I have has had her gall bladder removed. No my youngest daughter (35) suffers gall bladder attacks. The doctors are showing no interest in removing it and she is presently controlling it by diet but it can flare in a heart beat if it doesn't like something. They've never prescribed a medication for her to take but 'maybe' a few pain killers from time to time but I tend not to think so.

She can't do pork at all, anything greasy, eggs, grapefruit is long gone and I know there are other things that just send her into fits of agony.

[Robbo70]

Giving up grapefruit was my biggest loss. I drank it by the litre and after 7pm, by the bloody big glass full with a hefty shot of vodka. Now I am reduced to orange cordial or vimto served weak with diet lemonade. Nothing greasy for me too, and predominantly white meat. Bland but effective

[Horus]

Hope you kept up the Vodka

[Robbo70]

oh hell yes... with the vimto and diet lemonade