White coat syndrome: causes and treatment - K Health (2023)

Even though your doctor has your best interest in mind, you may experience a littleanxietyat medical appointments.

For some people, this fear can even cause a phenomenon called white coat syndrome: blood pressure rises in the doctor's office, leading to ahigh pressurereading even if they have healthy blood pressure levels.

If you find that your blood pressure increases only occur when you are in a medical setting, it may be helpful to learn how to manage your anxiety.

In the otherhand, if you are diagnosed with high blood pressure (hypertension), changes in lifestyle and, if necessary,blood pressure medicationcan help treat the condition to reduce the risk of medical complications.

In this article, I will explain what white coat syndrome is, as well as the symptoms, causes and treatment of white coat syndrome.

I will also discuss the difference between white coat syndrome andhypertensionand when to speak with a doctor about any blood pressure concerns.

What is white coat syndrome?

White coat syndrome (also called white coat hypertension or white coat effect) is a condition where people with normal blood pressure levels havehigh pressureIn the office.

It's called "white coat syndrome" because health care workers often wear white coats.

Studiesshow that people who experience the white coat effect are at a higher risk of heart attack or stroke than people who have normal blood pressure readings at the doctor.

A rise in blood pressure at the doctor's office can happen to someone with normal range or high blood pressure.

So if you have a high blood pressure reading, your doctor will likely want to monitor your blood pressure to determine if you have high blood pressure.

Chat with a doctor online using K Health.


Symptoms of White Coat Syndrome

The most significant sign of white coat syndrome is high blood pressure at doctor visits.

(Video) Overcoming white coat syndrome

A high blood pressure reading is defined as 130/80 mm Hg or higher.

Other symptoms of white coat syndrome are less clear.

However, because white coat syndrome can be associated with anxiety, you may experience a racing heart,sweating, or a general feeling of being on edge.

Causes of white coat syndrome

The exact causes of white coat syndrome are uncertain.

Anxietyfor any reason can trigger a temporary increase in blood pressure.

So, at first, experts believed that anxiety about seeing the doctor caused white coat hypertension.

Now, some evidence suggests thatWhite coat syndrome may be an early sign of high blood pressure.

That's why it's important to monitor your blood pressure — and manage your anxiety — if you have white coat syndrome.

Treating White Coat Syndrome

If your doctor is concerned about white coat syndrome, he or she will monitor you for hypertension.

Because it can be difficult to get an accurate reading with a blood pressure cuff in people with white coat hypertension, your doctor may encourage you to return for another appointment or ask you to monitor your own blood pressure at home.

If you are diagnosed with hypertension, your doctor may encourage lifestyle changes, prescribe medication, or recommend both treatments.

Or if you have white coat syndrome due to anxiety, the following coping tools can help reduce your stress and, in turn, provide you with a more accurate blood pressure reading at your doctor's office.

Practice stress relief

If you tend to experience anxiety, work on managing your stress between doctor appointments.

The evidence-based coping mechanisms below can help reduce stress and, hopefully, your blood pressure readings:

  • progressive muscle relaxation: This exercise involves relaxing each muscle in the body, one group at a time. To start, take a deep breath. Then, starting at the head, tighten and then relax each muscle group one by one, slowly working your way down to your toes.
  • Exercise: Whether you go for a walk, take a yoga class or hit the gym,physical activityIt has been shown to reduce stress, so try to incorporate exercise into your routine on a regular basis.
  • seeking support: Everyone needs support from time to time. If you are struggling with stress, it can be helpful to share your feelings with a loved one or a psychotherapist.

calm down/relax

If you feel nervous while waiting for your doctor to measure your blood pressure, try to calm down.

Taking deep breaths, listening to soft music, or visualizing something relaxing can help. It may also help to let the provider know that you are feeling nervous.

Or you can ask the doctor or nurse to wait until later in the appointment (when you feel more comfortable) to take your blood pressure.

(Video) “White Coat Syndrome” or “White Coat Hypertension:” Doctor Explains What It Is & How to Manage It

move rooms

If you are in a noisy or crowded area, ask the person taking your blood pressure if you can move to another room.

Dimming the lights in the room can also help you calm down.

change your focus

Distraction can be another useful tool for white coat syndrome.

While you shouldn't speak during the blood pressure reading, you can look around the room or think of something else (preferably something or someone that helps you feel happy or calm).

Difference between white coat syndrome and hypertension

It can be difficult to understand whether you have white coat syndrome, high blood pressure, or both.

It would be useful forto checkyour blood pressure at home at different times during the day on different days and bring a record of these values ​​to your appointment.

If your blood pressure readings are normally normal, except when you're at the doctor's, you may have white coat syndrome without underlying hypertension.

To be sure, your doctor willkeep monitoring your blood pressureto see if you develop high blood pressure over time.

Such monitoring will also help determine whether white coat syndrome is an early sign of high blood pressure or another underlying condition.

If you have hypertension, your blood pressure will remain constantly elevated whether you are in a health care provider's office or in another setting.

Chat with a doctor online using K Health.


When to see a doctor

No matter what causes it, high blood pressure increases your risk of developing medical complications likeheart diseaseeAVC.

If you're concerned about your blood pressure, talk to your doctor, who can diagnose and treat you.

(Video) White coat Hypertension

Likewise, talk to your doctor if you're struggling with anxiety.

It's normal to feel anxious from time to time, but if your worries interfere with your everyday life, treatments such as therapy, medication, or both can help you manage your anxiety.

How K Health can help

Did you know you can get affordable primary care with the K Health app?Download Kto check your symptoms, explore conditions and treatments, and if needed, text a doctor in minutes. K Health's AI-powered app is HIPAA compliant and based on 20 years of clinical data.

common questions

Is white coat syndrome a form of anxiety?

White coat syndrome can be a result of anxiety. If anxiety interferes with your daily functioning, talk to a doctor about treatment options. Likewise, if you are concerned about your blood pressure, talk to your doctor.

How serious is white coat syndrome if left untreated?

You may experience a momentary rise in blood pressure in the doctor's office for a variety of reasons, and it can be an early sign of high blood pressure. That's why it's important to monitor your blood pressure if you have white coat syndrome. If you are diagnosed with high blood pressure, medications and lifestyle changes can reduce your risk of cardiovascular disease and other medical conditions.

(Video) The Secrets to Solving White Coat Syndrome and Doctor Anxiety

Can white coat syndrome lead to hypertension?

Anxiety can increase your risk of developing high blood pressure. Talk to your doctor or psychotherapist to learn how to manage your stress. It is also possible that white coat syndrome is a sign of developing high blood pressure; your doctor can help you understand your risk and, if necessary, suggest treatment options.

K Health articles are all written and reviewed by MDs, PhDs, NPs or PharmDs and are for informational purposes only. This information does not constitute and should not be construed as professional medical advice. Always talk with your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.


What can you do to stop white coat syndrome? ›

How is white coat syndrome treated?
  1. Exercising more often.
  2. Losing weight.
  3. Reducing how much salt you eat.
  4. Avoiding the use of tobacco products.
Aug 3, 2022

What is the reverse of white coat hypertension? ›

Similarly, patients with a condition called “masked hypertension” that is the reverse of white coat hypertension – normal blood pressure in their physician's office but high readings at home – have more cardiovascular events than patients with consistently normal blood pressures.

Does anxiety cause white coat hypertension? ›

Anxiety. Whether it's the tightening of the arm-cuff or the fear of a potential diagnosis, the anxiety brought on by anticipation can be enough to raise your blood pressure. Those who have been diagnosed with generalized anxiety are more likely to suffer from White Coat Hypertension.

What is the number one food that causes high blood pressure? ›

Salt or sodium

Salt, or specifically the sodium in salt, is a major contributor to high blood pressure and heart disease. This is because of how it affects fluid balance in the blood. Table salt is around 40 percent sodium. Some amount of salt is important for health, but it's easy to eat too much.

What are 7 drinks to lower blood pressure? ›

The top drinks for lowering blood pressure include:
  • Water.
  • Fruit juices. Pomegranate. Prune. Cranberry. Cherry.
  • Vegetable juice. Tomato. Raw beet.
  • Tea. Black. Green.
  • Skim milk.

What is the best treatment for white coat hypertension? ›

The most commonly used medications are Angiotensin-Converting Enzyme (ACE) inhibitors, Angiotensin II Receptor Blockers (ARBs) and calcium channel blockers. Diuretics and adrenergic blockers can also be helpful in controlling blood pressure.

Why do people get white coat syndrome? ›

PHILADELPHIA – White coat hypertension, a condition in which a patient's blood pressure readings are higher when taken at the doctor's office compared to other settings, was originally attributed to the anxiety patients might experience during medical appointments.

What time of the day is blood pressure highest? ›

Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening. Blood pressure is usually lower at night while sleeping.

Why do I have white coat syndrome? ›

You could have white coat hypertension. This condition occurs when blood pressure readings at a health care provider's office are higher than they are in other settings, such as at home. It's called white coat hypertension because people who measure blood pressure sometimes wear white coats.

Can drinking water lower blood pressure? ›

Still, you can make lifestyle changes to bring your blood pressure down. Something as simple as keeping yourself hydrated by drinking six to eight glasses of water every day improves blood pressure. Water makes up 73% of the human heart,¹ so no other liquid is better at controlling blood pressure.

Does white coat syndrome affect heart rate? ›

Compared with people whose blood pressure was normal both at the doctor's office and at home, people with untreated white-coat hypertension had a 36% higher risk of heart attack, stroke, and other heart-related events. They were also twice as likely to die from heart disease.

Do bananas lower blood pressure? ›

Bananas. These are rich in potassium, a nutrient shown to help lower blood pressure, says Laffin. One medium banana provides about 375 milligrams of potassium, about 11 percent of the recommended daily intake for a man, and 16 percent for a woman.

What is the number one food to lower blood pressure? ›

1. Citrus fruits. Citrus fruits, including grapefruit, oranges, and lemons, may have powerful blood-pressure-lowering effects. They're loaded with vitamins, minerals, and plant compounds that may help keep your heart healthy by reducing heart disease risk factors like high blood pressure ( 4 ).

What drinks increase blood pressure? ›

Drink Caffeine

Beverages like coffee and caffeinated tea cause an increase in heart rate and a temporary spike in blood pressure.

Why are bananas bad for high blood pressure? ›

Foods high in potassium also can interfere with some medications for high blood pressure and heart failure. It certainly would take more than one banana to raise potassium levels to a dangerous level for the average person, Spees said.

What is the best drink in the morning for high blood pressure? ›

Consuming drinks like tomato juice, beet juice, pomegranate juice, and skimmed milk as part of a balanced, healthy diet can help you manage high blood pressure.

Does lemon water bring your blood pressure down? ›

Lemon drink contains traces of several minerals that may be beneficial in lowering blood pressure. Calcium and potassium both can lower blood pressure in those suffering from hypertension. A study suggests that lemon water can help bring the number to the normal range immediately.

Can drinking lemon water reduce blood pressure? ›

Infused Water

Citrus, such as lemon and limes, has been shown to reduce blood pressure and has the added benefit of adding a little flavor to a boring glass of water.

Why do I get nervous when checking blood pressure? ›

Patients often are nervous about what their blood pressure will be when it's measured at their doctor's office, and that anxiety causes their blood pressure to go up. It's known as “white coat hypertension,” and it's particularly common among elderly patients.

Do deep breaths lower blood pressure? ›

Slow, deep breathing activates the parasympathetic nervous system which decreases the heart rate and dilates blood vessels, reducing your overall blood pressure.

What is the blood pressure release trick? ›

Take a deep breath from your core, hold your breath for about two seconds, then slowly exhale. Pause for a few moments and repeat. Relax! Stress is a key contributor to high blood pressure, so do whatever you can to relax.

How do I stay calm to lower my blood pressure? ›

Stress-reducing activities can help lower blood pressure
  1. Adjust your schedule. If you have too much to do, look at your calendar and to-do lists. ...
  2. Breathe to relax. Taking deep, slow breaths can help you relax.
  3. Exercise regularly. ...
  4. Try yoga and meditation. ...
  5. Get enough sleep. ...
  6. Change how you see challenges.

Can anxiety meds help with white coat syndrome? ›

This is often attributed to the anxiety that surrounds doctors and hospital settings. Medications aren't a solution for white coat hypertension.

What is the permanent cure for high blood pressure? ›

There is no cure for high blood pressure. But treatment can lower blood pressure that is too high. If it is mild, high blood pressure may sometimes be brought under control by making changes to a healthier lifestyle.

How long does it take for a glass of beet juice to lower blood pressure? ›

How long does it take for a glass of beetroot juice to lower blood pressure? Drinking beetroot juice can reduce blood pressure levels after an hour. After ingestion, hours later blood pressure will reach the lowest point and will continue to have an effect on the levels up to 24 hours after taking your beetroot juice.

Does beet juice really lower blood pressure? ›

Beetroot juice (BRJ) is rich in nitrate (NO3) and has the potential to reduce blood pressure (BP). NO3 is a precursor for the production of nitric oxide (NO) and increases its concentrations in the bloodstream, optimizing endothelial function (e.g., vasodilation) (1).

Can I drink beet juice while taking blood pressure medication? ›

Beetroot juice is rich in nitrates, which might negatively interact with certain blood pressure-lowering medicines, leading to a severe drop in blood pressure.

What is ideal blood pressure by age? ›

What is Normal Blood Pressure by Age?
18-39 years110/68 mm Hg119/70 mm Hg
40-59 years122/74 mm Hg124/77 mm Hg
60+ years139/68 mm Hg133/69 mm Hg
Nov 4, 2022

Is white coat syndrome a mental disorder? ›

If you feel nervous or very anxious around healthcare professionals, the term “white coat syndrome” might apply to you. While not an official diagnosis, it's a term often used to describe the rise in blood pressure that some people get in uncomfortable settings, like at a doctor's office.

What medication is used for anxiety and high blood pressure? ›

Propranolol belongs to a group of medicines called beta blockers. It's used to treat heart problems, help with anxiety and prevent migraines. If you have a heart problem, you can take propranolol to: treat high blood pressure.

What is normal blood pressure for a 70 year old? ›

Normal blood pressure for most adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80.

Which arm do you take blood pressure? ›

The device should measure blood pressure on the upper arm, which produce a more reliable result than those that measure from the wrist.

What time of day should you not take your blood pressure? ›

Don't measure your blood pressure right after you wake up.

You can prepare for the day, but don't eat breakfast or take medications before measuring your blood pressure.

How can I calm my nerves before going to the doctor? ›

7 ways to combat doctor's office anxiety
  1. Schedule at a good time of the day or week. ...
  2. Take a friend or family member with you. ...
  3. Control your breath. ...
  4. Try self-hypnosis. ...
  5. Mentally prepare ahead. ...
  6. Be honest about your anxiety. ...
  7. Have your vitals taken last.
Nov 13, 2018

How rare is white-coat syndrome? ›

Studies show that nearly 1 in 5 people experience white-coat syndrome. While it usually isn't a cause for concern or treatment, it can be confused with actual, chronic hypertension (or high blood pressure), if not careful.

Should I be scared to take blood pressure medication? ›

"If lifestyle changes alone don't work, people shouldn't be afraid to take medication to get their blood pressure to a normal range," Dr. Brayer says.

What supplements should I avoid if I have high blood pressure? ›

Examples of herbal supplements that may affect your blood pressure or blood pressure medicines include:
  • Arnica (Arnica montana).
  • Ephedra (ma-huang).
  • Ginseng (Panax quinquefolius, Panax ginseng).
  • Guarana (Paullinia cupana).
  • Licorice (Glycyrrhiza glabra).

What are three easy exercises to lower blood pressure immediately? ›

Some examples of aerobic exercise that can help lower blood pressure include walking, jogging, cycling, swimming or dancing. Another possibility is high-intensity interval training. This type of training involves alternating short bursts of intense activity with periods of lighter activity.

Does walking lower blood pressure? ›

Walking lowers systolic blood pressure by 4.11 mm Hg (95% CI, 3.01 to 5.22 mm Hg). It lowers diastolic blood pressure by 1.79 mm Hg (95% CI, 1.07 to 2.51 mm Hg) and resting heart rate by 2.76 beats per minute (bpm; 95% CI, 0.95 to 4.57 bpm).

What is the average blood pressure for white coat syndrome? ›

Definition. WCH describes an elevated clinic BP in the presence of normal out-of-office BP values. This BP phenotype is also referred to as white coat syndrome. The ESH suggest that patients with an office reading of at least 140/90 mmHg and a mean 24-h BP of less than 130/80 mmHg are deemed to have WCH.

What is the reverse of white coat syndrome? ›

The reverse of "white coat hypertension" (higher blood pressure readings at the doctor's office than outside the clinic setting), "masked hypertension" is normal blood pressure in the doctor's office but high readings outside of the office. Masked hypertension is easy to miss, and can occur during the day or night.

What is the number 1 fruit to lower blood pressure? ›

Berries: Strawberries and blueberries are rich in antioxidant compounds called anthocyanins. Research has linked anthocyanins to a reduction in blood pressure in people with hypertension. In more good news, berries are delicious!

Are eggs good for blood pressure? ›

Eggs are loaded with vitamins, minerals, good fats, and high-quality protein. An increased intake of protein has shown to be effective in controlling your blood pressure and reducing the risk of cardiovascular diseases. Dietary proteins such as eggs are known to have natural blood pressure-lowering properties.

Is peanut butter good for high blood pressure? ›

Peanut butter is high in protein and healthy fats, which can also help reduce blood pressure levels.

Does lemon water lower blood pressure right away? ›

Lemon drink contains traces of several minerals that may be beneficial in lowering blood pressure. Calcium and potassium both can lower blood pressure in those suffering from hypertension. A study suggests that lemon water can help bring the number to the normal range immediately.

What is the red drink to lower blood pressure? ›

Beet juice

A randomized pilot study from 2016 found that the juice of both raw and cooked beets improved blood pressure. But raw beet juice had a greater impact on blood pressure. Beets are rich in dietary nitrates, a compound known to have blood pressure-lowering effects.

Is apple cider vinegar good for high blood pressure? ›

Using apple cider vinegar is one method people with high blood pressure used to manage the condition. It has become a popular natural remedy for high blood pressure and other health purposes, including lowering bad cholesterol and weight management.

What is the best juice for high blood pressure? ›

Beet juice is the best choice, as it can significantly lower blood pressure in about three hours. Consuming other beneficial drinks like tomato juice and pomegranate juice may not have immediate effects on blood pressure, but will work over a period of consistent use.

Is banana good for high blood pressure? ›

1. Bananas. These are rich in potassium, a nutrient shown to help lower blood pressure, says Laffin. One medium banana provides about 375 milligrams of potassium, about 11 percent of the recommended daily intake for a man, and 16 percent for a woman.

Does vinegar lower blood pressure quickly? ›

Will apple cider vinegar lower my blood pressure immediately? No. Apple cider vinegar is not proven to lower blood pressure at all. Rather, it may work in a roundabout way by potentially promoting weight loss, supporting lower cholesterol levels, and improving blood sugar control.

Does cinnamon lower blood pressure? ›

Cinnamon appears to help dilate and relax the blood vessels, which may help lower blood pressure.

What are the worst drinks for high blood pressure? ›

Drinking more than 4 cups of coffee a day may increase your blood pressure. If you're a big fan of coffee, tea or other caffeine-rich drinks, such as cola and some energy drinks, consider cutting down.

Can lack of sleep cause high BP? ›

How does a lack of sleep affect blood pressure? One reason a lack of sleep affects blood pressure is that sleep helps manage stress hormones like cortisol. If you don't sleep enough, your body can't properly regulate these hormones, which can lead to high blood pressure.

Does turmeric lower blood pressure? ›

Since turmeric can lower blood pressure, it may have additive effects with antihypertensive drugs ( 10 ). Turmeric can aid digestion by increasing stomach acid levels, which may inhibit the effectiveness of antacids ( 10 ).

How much apple cider vinegar should you drink a day to lower blood pressure? ›

Easy fix: Three teaspoons per day of apple cider vinegar can lower your blood pressure significantly within a week. If the taste is too much, mix it with a little warm water or add it to your favorite beverage (as long as it's not a sugary soda).

How long does it take for apple cider vinegar to clean arteries? ›

However, there are many natural remedies like Apple Cider Vinegar for blocked arteries. Scientifically 90% of people get relief from high cholesterol in just 30-40 days after using this remedy.


1. How to Control "White-Coat" Hypertension
(Dr. Stephen Sinatra)
2. White coat syndrome - The psychological link
(Generation Calm)
3. The dangers of white coat hypertension
(Click On Detroit | Local 4 | WDIV)
4. White Coat Syndrome Symptoms - Scared to go to the Doctor?
(Trey Jones)
5. 'White coat syndrome' a sign of high blood pressure not to be ignored
6. WHITE COAT HYPERTENSION EFFECT, Does white coat effect blood pressure?


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