White-Coat Hypertension Not Benign
Study Shows Condition Doubles Risk for Sustained High Blood Pressure
Getting an Accurate Reading
Stein says patients who think their in-office blood pressure readings may be too low or too high should check their blood pressure at home.
Home monitors can be purchased for as little as $20, but it is a good idea to bring the device to your doctor's office to make sure that it is accurately calibrated.
He recommends that his heart patients with suspicious in-office readings test their blood pressure twice a day for a week before being checked again in his office.
"They will come in with about 14 readings, which gives me a better idea of what is going on than one or two readings in the office," he says.
Tips for getting an accurate reading at home include:
- Avoid caffeine, tobacco, or medicines known to raise blood pressure (such as nasal decongestant sprays) for at least 30 minutes before testing,
- Avoid exercise for at least 30 minutes before testing,
- Sit quietly with both feet on the floor (not crossed) for at least five minutes before taking your blood pressure.
- Check the blood pressure cuff frequently to make sure the rubber tubing, bulb, valves, and cuff are in good condition. Even a small hole or crack in the tubing can lead to inaccurate results.
Most people with consistently high doctor's office blood pressure readings (140/90mmHg or above) do have clinically meaningful high blood pressure, but others don't.
If you get particularly anxious or nervous when you visit the doctor, and your blood pressure is between 140/90 mmHg and 160/99 mmHg in this setting, you may have white-coat hypertension.
For the best chance of a good blood pressure reading in the clinical setting, try deep breathing, meditation, or other stress-reducing measures before visiting the doctor.
Make sure your feet are not crossed when your pressure is being tested; crossing your feet causes blood pressure to rise. It is also helpful to breathe in slowly and deeply and breathe out through pursed lips during testing.