Can't pass DOT physical - high BP - High & Low Blood Pressure Message Board

Lend27 · 12-31-2006, 07:14 AM

I have mild high BP.
I have been on Analipril for the past 5 years.
My readings at home are in the 130/80 range. In the doctor's office they are initially higher, then after a 15 min rest they go back to normal. Dr. says I have white coat syndrome.
Now, I am trying to pass a DOT physical to become a truck driver.
When I am being tested by the company doctor, my BP jumps to anywhere from 165/95 to 200/110. My heart starts racing up to around 100 BPM.
The lowest I've been able to get it in the doctors office has been 150/88 and that was after over 30 minutes of resting. The highest reading they will accept is 140/90.
I went back to my doctor and he put me on Atenolol 50 mg.
When I take my readings at home I am in the 130/80 range. Pulse around 60.
I took my cuff to the doctors to check and it is very accurate.
Took my BP this am and it is 130/77.
I know that when I am exposed to anxiety or stress my heart races and my BP rises. I can feel it. My face gets hot, my ears get red, my head pounds.
I went back to the doctor after a week on the Atenolol and my BP was
190/110.
Went back home and the reading was 134/88.
I need to keep this job.
I have to pass this DOT physical.
Any suggestions?

Barbara_Ann · 12-31-2006, 08:52 AM

Good grief - thought I had white coat syndrome, you really have it.

I bet part of those numbers are additional stress at the moment pressure is being taken of failing the dot requirements.

My brother wanted in the army when he was 30 and has hbp. Before his physical he took several aspirin so his blood pressure would be in the acceptable range. lol

He knows how to get around all those type things - studied anatomy etc. in college.

Worked for him - might try that

I did the samething along time ago before I really had high blood pressure (per se') and was just little too high to give blood. I remembered my brother did that - I took couple of aspirin, waited few minutes and I was in the acceptable range to donate.

Good luck

Teacupforme · 12-31-2006, 04:30 PM

I know how you feel. I don't have whitecoat per say, but whitecoat is a form of anxiety. I have anxiety related to stressful situations like meeting new people or lunch with the boss.

In these situations my BP goes up high and I get shakey and disorientated. My GP kept upping my meds,and then at home or under normal circumstances,my BP became very low.

So in my situation the only way to get my BP under control was to get the anxiety under control, as upping my meds was not a solution.

I'm still working on the anxiety issues, but recognizing the problem is the first step.

I am not recommending this for you, but I take a small amount of valium on occasion just to relax and feel more comfortable. It's the only thing that stops that entire symapthetic chain reaction in my case.

Lenin · 01-01-2007, 07:47 AM

Lend,

White Coat Hypertension is bad enough when it is only an unbelieving doctor one has to contend with. When one's job is on line it must be HORRIBLE. With the stakes being so much higher, your anxiety level is enormous and the chance of getting a decent BP reading in conditions like that are impossible.

IF your doctor is filled with the milk of human kindness, he might prescrible something strong enough to use when you MUST show a good number...but I know, I am probably kidding myself since most are so rigid they wouldn't prescribe this way any more readily then they'd prescribe barbiturates or opiates.

If it were I, I would probably double my dose of atenolol for the day before and the day of the test. I would also two or three days of a diuretic to make sure there is no excess water weight. Alternative to the latter idea is to have three days of absolutely NO salt: Eat boiled rice, bland fish and steamed or sauteed vegetables. Keep sodium below 500 mg./day and thus read every label if you decide to add any prepared food. Don't eat anything away from home.

A valium, librium, or xananx the day before and the day OF the test will help.

Remember though, it is possible there is no cure. With me I can usually PASS a little more than half the time, but if a job were on the line, I don't know if I could pull it off.
My specific routine is that I normally take a low dose of Cozaar and some Lasix. I double both the day of the test (a new referrral, dentist, etc.) and add valium and propranolol.

I know, that's not the way to manage one's health but one does what he has to when confronted with a syndrome as unfairly vexxing as White Coat Syndrome. "Yah gotta do what yah gotta do."

Try asking your doctor for a recommendation and see if he can give any advice or better yet, an Rx! Fingers crossed. At the very least he should part with a tranquilizer.

TLB50 · 01-02-2007, 04:26 PM

Many people have White Coat Hypertension but I can't imagine having your job depend on a good reading. Fortunately, my doctor is supportive and just tells me to keep checking BP periodically at home. Unfortunately, there doesn't seem to be a "cure" for this problem. Lenin's advice is probably the best you are going to get.

I always have high readings at the doctor's office and I have even progressed to the point where my first reading at home is almost always high. Second and third readings are always 20-25 points lower. I can only attribute the problem to anxiety that I am going to have a high reading. After the initial reading, I relax and the BP comes down. You might try taking your BP at home BEFORE the test just to assure yourself that you are okay. Good luck.