Do you ever go to your doctor’s office and, when your blood pressure is checked, each time the cuff on your arm is pumped, that your blood pressure is rising, just because you don’t like being there, or are upset, nervous, rushed, or just around doctors? You may suffer from what is called “white coat hypertension”.
Up to 20% of people have white coat hypertension, which is a falsely high blood pressure reading that might lead you to be put on blood pressure medication, or to have your medication dose increased, just because you may be nervous around doctors.
Below we mention some other factors that can cause an artificially high reading of your blood pressure. It is good to be aware of these if your doctor or assistant says “your pressure is high”.
In the ideal case, your doctor or the assistant will take up to three readings of your pressure and average the three, but this is rarely done. Also it is best to check your pressure after you have been seated comfortably for a few minutes (up to 5), your legs should be uncrossed, and your upper arm should be at the level of your heart. (If your blood pressure readings in this situation is above 140/90, you may indeed have high blood pressure.)
But more likely, you get into the doctor’s office after waiting too long, and while you have your pressure taken, you are being asked about problems or medications. Maybe you are in a hallway or in front of others passing by, or your bladder is full. All these factors can raise your pressure artificially.
1. You have a full bladder (10-15 mm Hg)
2. Your back is not supported (5-10 mm Hg)
3. Your feet are not supported (5-10 mm Hg)
4. Your legs are crossed (2-8 mm Hg)
5. Blood pressure cuff is over clothing (10-40 mmHg)
6. Your arm is unsupported (10 mm Hg)
7. You are having a conversation (10-15 mm Hg)
So if your blood pressure reading is high, do your best to mention if any of these issues might be a factor, and recheck your pressure in a more ideal situation or when you are more relaxed.
But still, some people will have an artificially elevated blood pressure whenever they are in a medical setting. In these cases, it’s best to measure your own pressure at home on a few occasions. If you buy a home unit, try to buy one with an arm cuff (the finger or wrist units are not as accurate), and check with your pharmacist to make sure you buy a cuff with the proper size for your arm.
Home monitors are also good for hypertensive people who want to monitor their treatment. Another approach (more costly but more accurate) is to have a 24-hour monitor placed at your doctor’s office. You wear a cuff that periodically inflates throughout the day and night, with a cellphone sized recording unit you attach to your belt.
Don’t hesitate to have your blood pressure treated if indeed it is high after multiple readings. Untreated hypertension gives you a higher risk of heart attack, atherosclerosis, stroke, kidney disease, and other problems. Some people can lower their pressure by losing weight, exercising, minimizing salt intake, limiting alcohol intake and increasing intake of fruits and vegetables, but if these measures are not adequate, there are many good options for blood pressure medication available.
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