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What Is White Coat Syndrome?

Posting Date: 08/02/1999

Q: I understand you have written about White Coat Syndrome, and I'm very interested. I believe I suffer from it. I take Cardizem to control my blood pressure. At home it runs about 130/55 with a pulse of 45 to 50 and I feel fine. At the doctor's office it runs very high, and he keeps saying I should be on more medicine. I'm not convinced I like that idea. Any information you can send me would be appreciated.

A: You may be experiencing "white coat hypertension." Some people with normal blood pressure at home develop high readings in the doctor's office. In some cases blood pressure measurements may be 30 points higher. A few individuals are so reactive that their numbers may jump 75 mm above baseline when the nurse or doctor takes their pressure. Treatment of white coat hypertension remains controversial. Many physicians now believe that aggressive drug therapy for blood pressure that is high only in the doctor's office may lead to excessive costs and possible side effects. Check out our Guide to Blood Pressure Treatment, which discusses this issue and describes medications such as Cardizem, Norvasc, Vasotec and Zestril.