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All information on high blood pressure (hypertension) blood pressure measuring blood pressure causes of high blood pressure high blood pressure level white coat syndrome symptoms of high blood pressure diagnosis of high blood pressure isolated systolic hypertension causes of isolated systolic hypertension white coat hypertension borderline hypertension malignant hypertension labile hypertension pulmonary hypertension renovascular hypertension high blood pressure risk factors complications of high blood pressure body weight and hypertension treatment options for high blood pressure high blood pressure medications lifestyle for hypertension high blood pressure diet

What is white coat syndrome?

White coat syndrome is a situation where patients have high blood pressure in the doctor's office but nowhere else. The situation is generally not this clear-cut, however, and often the patient has occasional episodes where the blood pressure is high when taken at home, but it is reliably high when taken in the physician's office. Some patients with sustained high blood pressure will have higher readings in the doctor's office than at home. It is really not very uncommon. The patient generally

does not feel the slightest bit of apprehension when coming to the doctor, or even in the office when the blood pressure is high. The mechanism appears to occur at a subconscious level.

If blood pressure is just very occasionally high, it is not as dangerous as when it remains elevated most of the time. If in fact the blood pressure is noted to be high almost exclusively in the doctor’s office, many physicians will not prescribe any treatment at all. Some studies have suggested however that white coat hypertension may "turn into" sustained high blood pressure. This really makes more sense to me since the same types of stresses occur in everyday life.

There are two main problems or dangers with this condition:

  • The first is the tendency for some patients to put themselves in this category, saying to themselves "it's only high at the doctor's office . . . I don't need any treatment".
  • The other danger is that the high reading taken in the doctor's office is assumed to be the patient’s usual blood pressure, and he or she is overtreated.
  • The most prudent course seems to be:

  • Monitor patients with white coat syndrome closely. Obtain a blood pressure cuff and have your blood pressure taken on multiple occasions. Write the readings down and bring them to your physician.
  • There are devices which can be worn for 24 hours to measure the blood pressure throughout the day. These may be useful in providing a clearer picture of how long and under what circumstances a person's blood pressure may be elevated.
  • Continue to follow the general rules noted above: strive to maintain ideal body weight, avoid overuse of salt and sodium, and follow an exercise program.
  • More information on high blood pressure

    What is blood pressure? - Blood pressure or arterial blood pressure is the pressure (force per unit area) exerted by the blood on the walls of the blood vessels.
    What is high blood pressure (hypertension)? - High blood pressure or hypertension means high pressure (tension) in the arteries. High blood pressure is generally defined as a level exceeding 140/90 mm Hg that has been confirmed on multiple occasions.
    How to measure blood pressure? - Arterial blood pressure is usually measured in millimeters of mercury (mm Hg) using a sphygmomanometer.
    What causes high blood pressure? - High blood pressure is far more common in families where other members have this condition. There are also many other factors which are related to high blood pressure.
    At what level is blood pressure too high? - Blood pressure is generally felt to be abnormally high at a level of 140/90, and some sort of definitive therapy and follow-up should be started at this level.
    What is "white coat syndrome"? - "White coat syndrome" is a situation where patients have high blood pressure in the doctor's office but nowhere else.
    What're the symptoms of high blood pressure? - High blood pressure usually causes no symptoms. Sometimes people with high blood pressure have symptoms including headache, dizziness, blurred vision and nausea.
    How is high blood pressure diagnosed? - The diagnosis of high blood pressure is made on the basis of many blood pressure readings. It is diagnosed if several readings show a systolic blood pressure greater than 140 or a diastolic blood pressure greater than 90.
    What is isolated systolic hypertension? - Isolated systolic hypertension (ISH) is defined as elevated systolic blood pressure in conjunction with normal diastolic blood pressure (<90 mm Hg).
    Why and how isolated systolic hypertension (ISH ) develops? - Factors that may play a role in the high prevalence of ISH seen in Western societies include increased body fat, sedentary lifestyle, and increased sodium intake.
    What is white coat hypertension? - White coat hypertension should be considered when blood pressure readings are significantly elevated in the absence of target-organ damage.
    What is borderline hypertension? - Borderline hypertension is a blood pressure level which is in the 'gray zone' between normal and high (for example, someone with an average pressure of about 140/90 mmHg).
    What is malignant hypertension (arteriolar nephrosclerosis)? - Malignant hypertension is an acute emergency requiring immediate treatment in hospital.
    What is labile hypertension? - 'Labile' means variable, and just about everyone with hypertension has 'lablie hypertension.'
    What is pulmonary hypertension? - Pulmonary hypertension is high blood pressure in the pulmonary circulation (the arteries which go to the lungs). The blood pressure in the arms and the rest of the body is normal or low.
    What is renovascular hypertension? - Renovascular hypertension is a secondary form of high blood pressure caused by a narrowing of the renal artery.
    What're the risk factors for high blood pressure? - Controllable factors contribute to high blood pressure include sodium (salt) sensitivity, obesity and overweight, heavy alcohol consumption, use of oral contraceptives and some other medications, and sedentary or inactive lifestyle.
    What're the complications of high blood pressure? - Blood vessels can narrow due to high blood pressure and the accumulation of cholesterol. Blockage of arteries in the brain can lead to stroke. Blockage of blood vessels in the kidneys can lead to kidney failure.
    How does body weight affect hypertension? - Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels.
    What're the treatment options for high blood pressure? - The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Treatment may occur at home with close supervision by the health care provider, or may occur in the hospital.
    What medications are available for high blood pressure? - Medications may include diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or alpha blockers.
    Which lifestyle modifications are beneficial in treating hypertension? - Lifestyle modifications refer to certain specific recommendations for changes in diet and exercise.
    What is a good high blood pressure diet? - A good high blood pressure diet is not only rich in important nutrients and fiber but also includes foods that contain far more electrolytes, potassium, calcium, and magnesium, than are found in the average American diet.
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    All information is intended for reference only. Please consult your physician for accurate medical advices and treatment. Copyright 2005, health-cares.net, all rights reserved. Last update: July 18, 2005