Can a Pharmacy also cause white-coat hypertension?
I am facing somewhat of a dillema. Me and my doctor have discovered that no matter what the dosage of my medication my blood pressure reaches 160/70 in her office. She found this of particular interest since she noted that I get a very high heart rate "extremely nervous" and my diastolic stays perfect at 70. I am too young to have any CAD and indeed my cholestrol levels are stellar. She decided to lower my medication pretty drastically, instead of taking 40mg lisinopril with 25 mg of hydrochlorothiazide I am taking about 10 mg lisinopril with 25 mg hydrochlorothiazide. I feel she may have also done this as I recently lost 37 lbs.
The same occurs, high readings at the office with a low diastolic. At home however my readings RARELY go about 140/80 and I have 2 different machines to take note of the difference. My doctor is fairly pleased with this and says I have "White Coat" hypertension with some possible mild high blood pressure and to continue taking a low dose of the meds.
However when I go to CVS pharmacy I experience the same elevated readings, although usually not as high "140-145/75-80" and I also experience the same fear, heart palpitations and dry mouth that I get when I go the doctors office. The mix of people waiting for me to finish taking it so that they can take theirs, the pharmacists directly near the blood pressure machine and just the fact that people walking around seems to make me nervous, almost as if I am worried THEY are going to look at my blood pressure readings over my shoulder.
Is it possible to get this white-coat effect without necessarily having seen a white coat? In this case I do see some pharmacists with white coats walking around, but it's really having to be so close to other people also awaiting their readings that really makes me nervous and my heart rate to go wild.
Another interesting thing to note is that when taking my blood pressure at CVS, my heart rate is almost always in the 115's-120's as soon as I calm down at home my heart rate falls back to 70-85 range.
Question #2: How do you guys/gals personally feel about my doctors course of action? Do you think it is irresponsible? I must say I haven't felt this good in about a year, but I guess feeling good doesn't always mean being healthy. She also gave me some clonozepam for my anxiety, although I am scared to take it because I don't want to die of too low a heart rate.
Last edited by dantescritic; 02-25-2012 at 12:46 PM.
Re: Can a Pharmacy also cause white-coat hypertension?
"Is it possible to get this white-coat effect without necessarily having seen a white coat?"
"white coat" syndrome doesn't mean it's triggered by a white coat It's just the name they give it because so many people register higher than normal readings because of the underlying stress when they see a doctor, so if you have a machine at home there's no point in getting it tested at the pharmacy because you're not in a calm state and the reading is elevated from your anxiety, the same as it is at the doctor.
Last edited by captjane; 02-25-2012 at 07:47 PM.
The Following User Says Thank You to captjane For This Useful Post: dantescritic (02-26-2012)
Re: Can a Pharmacy also cause white-coat hypertension?
Not sure if this makes a difference but when this occurs my systolic shoots up to 150-160, my diastolic stays calm at 70-75 and my pulse rate is in 110-115.
I tried to control myself and was finally able to get a 130/70 reading at the pharmacy, though now I am worried that it wasn't accurate as I got a few lows but initially those scary highs.
Sooo frustrating, which should I believe?
Last edited by dantescritic; 02-26-2012 at 06:03 PM.
Re: Can a Pharmacy also cause white-coat hypertension?
Quote:
Originally Posted by dantescritic
Not sure if this makes a difference but when this occurs my systolic shoots up to 150-160, my diastolic stays calm at 70-75 and my pulse rate is in 110-115.
I tried to control myself and was finally able to get a 130/70 reading at the pharmacy, though now I am worried that it wasn't accurate as I got a few lows but initially those scary highs.
Sooo frustrating, which should I believe?
my suggestion is to stop taking your BP at dr's office's and pharmacies because those places create anxiety for you and therefore unusually high readings. You BP always goes up as a natural response to high anxiety situations. For example your BP goes up when driving a car in traffic jams. Or when something is troubling or worrying you.
So here's my suggestion, take your BP at the place you are the most- at home. Take it in the morning and evening, after relaxing, same chair, same arm position, same measuring device, same time of day. Note the readings over several weeks- then you'll know your average BP range. As apparently you allready know because you said you do take readings at home and they are ok. If home readings become too high too often, you need to take action.
If most are normal readings, then you are doing very good and you know that a high reading at a DR or pharmacy is not normal for you, but simply caused by temporary anxiety, and really not cause for alarm. Go back home and take daily readings again and if back to normal, you are fine!
Last edited by easygoingguy; 02-26-2012 at 07:01 PM.
Re: Can a Pharmacy also cause white-coat hypertension?
same thing happens to me, in fact as silly as this sounds, i start freakin out as soon as i see the cuff. hmm, i wonder what the definition of fear of having your bp taken is. but at home my readings are good. but the initial high readings scared me as well, i try to relax when its being taken, im practically doing tai chi, helps a little but still anxious when its taken and before
Re: Can a Pharmacy also cause white-coat hypertension?
I have white coat syndrome. At the doctors it's high, in a hospital environment it's through the roof.
Even at home my measurements go up if I'm not careful. I find the best way to measure my BP is to do something on the computer at the same time which takes my attention such as checking my bank balance which means typing my serial number and password first. By the time I complete this I'm too busy to worry and the measurement is taken.
Re: Can a Pharmacy also cause white-coat hypertension?
Quote:
Originally Posted by dantescritic
I am facing somewhat of a dillema. Me and my doctor have discovered that no matter what the dosage of my medication my blood pressure reaches 160/70 in her office. She found this of particular interest since she noted that I get a very high heart rate "extremely nervous" and my diastolic stays perfect at 70. I am too young to have any CAD and indeed my cholestrol levels are stellar. She decided to lower my medication pretty drastically, instead of taking 40mg lisinopril with 25 mg of hydrochlorothiazide I am taking about 10 mg lisinopril with 25 mg hydrochlorothiazide. I feel she may have also done this as I recently lost 37 lbs.
The same occurs, high readings at the office with a low diastolic. At home however my readings RARELY go about 140/80 and I have 2 different machines to take note of the difference. My doctor is fairly pleased with this and says I have "White Coat" hypertension with some possible mild high blood pressure and to continue taking a low dose of the meds.
However when I go to CVS pharmacy I experience the same elevated readings, although usually not as high "140-145/75-80" and I also experience the same fear, heart palpitations and dry mouth that I get when I go the doctors office. The mix of people waiting for me to finish taking it so that they can take theirs, the pharmacists directly near the blood pressure machine and just the fact that people walking around seems to make me nervous, almost as if I am worried THEY are going to look at my blood pressure readings over my shoulder.
Is it possible to get this white-coat effect without necessarily having seen a white coat? In this case I do see some pharmacists with white coats walking around, but it's really having to be so close to other people also awaiting their readings that really makes me nervous and my heart rate to go wild.
Another interesting thing to note is that when taking my blood pressure at CVS, my heart rate is almost always in the 115's-120's as soon as I calm down at home my heart rate falls back to 70-85 range.
Question #2: How do you guys/gals personally feel about my doctors course of action? Do you think it is irresponsible? I must say I haven't felt this good in about a year, but I guess feeling good doesn't always mean being healthy. She also gave me some clonozepam for my anxiety, although I am scared to take it because I don't want to die of too low a heart rate.
IMO, you definitely do have White Coat Syndrome...I know...I have it too...If they took it at the pharmacy I, too, may show this same sign that you do....Just keep a record of what it is at home...
I think she is doing a good job....If you question what she is doing then get a second opinion...A patient must have confident on his/her doctor...Take care...ILDH
It's just the name they give it because so many people register higher than normal readings because of the underlying stress when they see a doctor, so if you have a machine at home there's no point in getting it tested at the pharmacy because you're not in a calm state and the reading is elevated from your anxiety, the same as it is at the doctor.
