Health Team

Home tests fight 'White Coat Syndrome'

Posted July 7, 2011

— The stress of visiting a doctor's office can throw off blood pressure measurements that determine what medications patients get, according to researchers at the Duke University and Veterans Affairs Medical Center in Durham.

John Goin, a 68-year-old Chatham County farmer, keeps close track of his blood pressure because of his family history with the disease that is a major cause of stroke, heart failure and kidney disease.

"My dad passed away at 54 years of age from extensive hypertension," he said.

Goin's daily routine includes measuring and recording his own blood pressure.

He discovered a significant difference between the numbers taken at his home and at his doctor's office.

"I'll look at numbers that are 10 to 15 points higher than what I had had at home before I left home," he said.

Those spikes in blood pressure at the doctor's office are called White Coat Syndrome. Doctors and patients had long suspected it, and recent work by Duke and VA researchers proves it.

"Even when it's measured properly, there's an impact of stress from being in a doctor's office," said Dr. Benjamin Powers, with the VA Medical Center in Durham.

Powers led a study of 444 patients comparing home tele-monitoring and clinic-only measurements. Decisions based on home measurements led to an almost 20 percent improved control of blood pressure.

"The evidence is actually shifting toward home measurement actually being a better predictor of those outcomes that are important for patients," Powers said.

white coat Home tests fight 'White Coat Syndrome'

May patients, including Goin, used equipment recommended by doctors in the study and learned how to use it properly.

"After every two weeks or so, my wife puts the results on (Microsoft) Excel and sends it to Dr. Powers," Goin said.

For long-term management, many changes to medications can be made without an office visit, Powers said.

Studies show that only half of people with hypertension are aware of it, and only half of those people have it well controlled. People should know their family history of heart or blood pressure problems and see their doctor regularly to catch those conditions early.


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  • Rohir Jul 8, 2011

    If my BP reading is a little higher than normal at the doctor's office, I will typically ask the nurse to retake it. It is almost always lower on the 2nd reading.

  • DAR-Patriot Jul 8, 2011

    Have had this problem forever. I go to give blood and my blood pressure is steady as a rock. I go to the doctor and it is high.

  • imtiredofit Jul 7, 2011

    Another thing that drives up a persons blood pressure when you visit the doctor is the way the doctor's staff take your blood pressure. On every blood pressure monitor the instructions say to make sure that you go to the bathroom 1st and then sit quietly for about 5 minutes before taking a reading.
    Now when you go into my doctors office, once you are called into the doctors area from the waiting room the 1st thing that happens is they rush you over to the scale for your weight, next they immediately take you into the examination room and wheel the blood pressure machine over to you and at the same time they stick a thermometer in your mouth and at the same time they start asking you questions about your current health and if anything has changed since your last visit. I've pointed this out to the doctor a number of times and he just shrugs this concern off but yet he will notate that my pressure is up a bit......