What is White Coat Syndrome?

Who Experiences White Coat Syndrome? 

White coat syndrome can affect anyone, but it is more common in: 

• Older adults
• Women
• People who are overweight

Is White Coat Syndrome Dangerous? 

While white coat syndrome may seem harmless, you should not ignore it. Research has shown that people with white coat syndrome may be at higher risk of developing chronic high blood pressure. 

If you have white coat syndrome, your physician may recommend keeping a close eye on your blood pressure with at-home monitoring, especially if you have other risk factors like diabetes, high cholesterol or a family history of heart disease. 

How Is White Coat Syndrome Diagnosed? 

When it comes to your blood pressure, it is important to get the right diagnosis. You and your physician need to know if an elevated reading is just a temporary spike or something more serious that requires treatment. To figure out whether you have white coat syndrome or a more chronic problem, your physician might recommend: 

• Ambulatory blood pressure monitoring — This involves wearing a portable device for 24 hours. The device checks your blood pressure automatically throughout the day and night.
• Home blood pressure monitoring — This involves using a blood pressure cuff at home to take readings several times a day over a week. You likely have white coat syndrome if your blood pressure readings are consistently normal outside the physician’s office. 

How Is White Coat Syndrome Treated?

 Most of the time, treatment for white coat syndrome does not mean medication, especially if your home readings are normal and you do not have other risk factors. Instead, your physician might suggest: 

• Lifestyle changes like eating a heart-healthy diet, getting regular exercise, managing stress, and limiting salt and alcohol
• Keeping track of your blood pressure at home and bringing those readings to your appointments
• Monitoring over time to make sure the condition does not progress into chronic high blood pressure (hypertension) 

Can You Prevent White Coat Syndrome? 

You may not be able to stop white coat syndrome, but there are things you can do to prepare for a medical visit to reduce the likelihood of a blood pressure spike. 

• Regularly take your blood pressure at home to get comfortable with the process.
• Schedule your appointment at a calm time of day, so you are not rushing or stressed.
• Let your physician know about your concerns. They may suggest taking your blood pressure after the visit instead of at the start. 

Tips for Staying Calm during a Blood Pressure Check 

• Arrive early so you have time to settle in.
• Avoid caffeine, smoking or heavy exercise for at least 30 minutes before your appointment.
• Sit with your back supported, feet flat on the floor and arm at heart level.
• Take a few slow, deep breaths and focus on relaxing your shoulders and neck. 

Some people like to sit silently during a blood pressure check. Others like to talk to distract themselves from the test. Do what works best for you. 

Can You “Outgrow” White Coat Syndrome? 

White coat syndrome can be lifelong, but it can improve with time. You may find your anxiety lessens as you become more familiar with your physician. This can result in more “normal” blood pressure readings at each appointment. 

If your white coat syndrome does not ease with time, it is important to continue with home monitoring and keep talking with your physician.