Whitecoat Hypertension even with meds. - High & Low Blood Pressure Message Board

ofacto · 06-24-2006, 06:53 PM

This is more of a rant. I have this problem where everytime I go to the doctor to get my BP checked, its always high even when I am on meds. It was 160/96 when I last went in. At home it always around 125/70 which isn't perfect but is good for me. This has caused problems, the nurses always accuse me of not taking my meds, and they always end up taking my blood pressure 4-5 times. They hide the the BP monitor from me and tell me to relax thinking that if I don't see the result it will make my blood pressure lower, but it has the opposite effect.

The problem is that while I am sitting in the waiting room I become very anxious and impatient, sometimes the wait is more than an hour and by then my blood pressure is already up. The absolute worst was when a nurse accused me of taking illegal drugs because my blood pressure was so high, he told me never to come back (I think I could have gotten this guy fired but I did nothing + I switched hospitals).

I really don't want to take anxiety medication as I am already taking 3 BP meds (they added an extra one after this last visit metoprolol + benaepril + norvasc).

Uff-Da! · 06-24-2006, 08:48 PM

I empathize with you. I never had "white coat" until last year when I went back to the doctor after having been off BP meds for six months without her previous "permission." I had been getting an average of 125/75 or so without them at home, so why continue on meds after my lifestyle changes? Anyway, I knew she would be upset that I hadn't asked her first, and since my BP is highly affected by stress, my initial BP was 161/something when the nurse first took it. And by the time I got done talking to the doctor, it was 181/something or thereabouts! Of course, they tried to tell me that it was my monitor that was off, but I bought a new one and still get similar readings at home. Anyway, ever since then, I've had white coat bad.

But my attitude is the doctor is working for me. I'm the manager of my own health; the doctor is merely the paid consultant. And just like a business manager, I can choose to go along with what the consultant recommends, but since I know more about my business than she does, I can also reject her recommendations. And I have. I haven't yet told her in so many words, but my attitude is "I will make the decisions based upon my home readings regardless of what readings you get in the office." Some day I might even tell her to forget about taking office readings, as they are worthless to me when I get upset. I do, however, take a record of my home readings with me when I go to the appointments. If she doesn't want to believe them, tough.

Lenin · 06-25-2006, 06:22 AM

ofacto,

My experience as a long term white coater: there is NO drug combo that will beat my white coat unless it's something like demerol to render me unconscious.

Best you can do is to get a thorough record of BP's at home and tell your doctor where to stick his sphygmomanometer.

Trying to medicate so a doctor sees good numbers is ultimately a silly way to go.

If your doctor won't believe your chart, find another.

Autumn1 · 06-25-2006, 07:19 AM

What amazes me most about having white coat hypertension is
the reaction from most doctors when you try to tell them. They look
at you with disbelief, like they are hearing this for the first time.
Then you feel guilty because you think you are the only one he or she
has seen with this in a long time.

In reality, your doctor probably sees patients with sky high office-only
readings all throughout the week. If they would only tell you they
understand, believe you and will work with you, the next visits would probably be less stressful. But in many cases the threat of more meds because of the high office readings and the raised eyebrows of the nurse or doctor taking your bp is enough to keep one in a contineous white coat state.

Lenin · 06-26-2006, 05:09 AM

Autumn,

The reaction is sort of "Of course, White Coat EXISTS BUUUUTTTTTT."
Then they go on with the stupid argument, "Well, if it's high in this office when ELSE is it high."
An then the non-sequitor "Do I make you NERVOUS?"

The answer to that last question, and I've actually used it is: "No, but you certainly are making me p*****d off!"

What will shut them up is to ask them to define hypertension...they stammer a lot. And they LOVE when you add "But doctor, you forgot 'sitting comfortably, relaxed, without legs dangling and NEVER on an examining table in a cold room!"" They always smile in appreciation to relearn that little item from med school.