Blood pressure question

[franglais123]

I’m quite an anxious person and feel stress quite physically. Whenever my BP is done at the doctor’s it’s high because I’m so anxious then it goes down a bit. When I’m at home and calm myself down with breathing exercises etc I can get my BP down to normal range (e.g. 122/80 just now). But surely it’s still not good for my BP to go so high whenever I’m feeling stressed? I’m working hard on being calmer (lots of exercise, yoga, doing a meditation course on Saturday) and I am a healthy weight with a decent diet but it does still worry me even though the doctors never seem concerned as they say it’s due to white coat syndrome. Anyone in a similar boat?

White coat syndrome is perfectly normal - and BP goes up and down throughout the day anyway (source - my GP). It's good that you're aware of stress and are taking steps to address it, but if the doctor isn't worried then if I were you I wouldn't be either.

Vitamin B complex is good for lowering stress

I wouldn’t worry if it only shoots up at the doctors, as I’m assuming that wouldn’t be too often. Your normal BP sounds fine.

BP can fluctuate during the day & 'white coat syndrome' is a known thing. If it comes down while you're there - and you have a decent reading otherwise they won't be too concerned. Occasional 'spikes' are fine, and an expected reaction to fear / stress. It's sustained high blood pressure that can be a cause for concern.

I think if you can get it down to a normal range then you're probably okay, high blood pressure under stressful conditions is pretty normal.

It's sustained high blood pressure that can be a cause for concern

Yup, this. I have a yearly medication checkup and before that I take a weekly record of my BP for the doctor. One one occasion it spiked in mid week (argument with psycho manager) and I felt obliged to account for that - which is when the GP made the comment about BP being up and down every day.

HCP here. There are different criteria for BP readings taken at surgery/clinic and readings taken at home. I probably see about 20 patients a day who's BP is higher than we would like. Your GP will likely ask you to keep a BP a record of home BP readings for 5+ days and then average them out and review accordingly.

My BP shoots up and down a lot, and I have an unusually large gap between the systolic and diastolic readings. I have an app that takes the readings from my BP monitor. My GP knows all of this and isn't concerned as long as I continue to take my medication for it.

I’m monitoring it for a week with a machine at home - the only way I can get a ‘good’ reading is if I really work at it like I said - deep breathing, almost meditating beforehand! So maybe it is consistently high the rest of the time? It was 138/93 the first time I did it before I spent 10 mins going into a zen like state! Or is that first reading from the white coat hypertension I’m getting just by looking at the machine and being anxious I’ll get a high reading?!

Try taking three readings in a row with a minute or two in between.

Watching with interest as I'm similar

@MissConductUS I do that but it’s still high. I can only get a ‘normal range’ reading if I’ve done a lot of work on calming down first!

138/93 really isn't a dangerous or classified as a hugely high BP reading in and of itself and wouldn't be considered cause for investigation or hospital involvement unless there were other things at play like a known condition, symptoms relating to the change in BP or if the reading were persistently high over time without a case or without dropping back to a lower reading in the circumstances you describe. You know the cause here, and it is also dropping back down once you have relaxed.

White coat syndrome is very real but equally you know you are having issues with anxiety and are obviously concerned about the BP issues so it stands to reason that it would be slightly elevated when you get your monitor out and measure it, then go back down after the fact when you're relaxing.

Honestly I think you'd probably be better off if you just put the blood pressure monitor away and stopped taking readings unless the GP has asked you to do one. I have a condition that causes tachycardia and a low blood pressure and have never found any benefit to constantly looking at readings (with the exception of when I am already very unwell and need medical assistance). Sporadic instances of slightly raised BP are not going to do you any harm, the body is fairly resilient and it's easy to become fixated on these things and cause a cycle of anxiety that will ultimately raise both blood pressure and heart rate and leave you feeling unnecessarily ill at ease.

Anxiety is a very difficult thing that causes a lot of physical symptoms. Has the GP offered any assistance in that respect?

@dontgobaconmyheart thank you - that’s a really helpful post. You’re probably right that I should step away from the monitor! However my GP surgery has asked me to do a diary of my readings (I think it’s a routine thing as my husband was asked at tjr same age) which is why I’m doing it so regularly. I’ll be interested to see if they ask to see me once I’ve handed them in.

And I don’t have anxiety in the sense that I have an anxiety disorder - I just react strongly in a stressy way to anything stressful! Health is probably the thing that stresses me the most and at the moment a couple of my friends are seriously ill which doesn’t help but on the whole I’m a happy person with a lovely life. Until I have to take my blood pressure, haha.

I'm the same- dentist or doctors!

I also have wondered the same, can't be great can it? I did read somewhere that white coat hypertension can be a sign that you will be more likely to develop high blood pressure later in life. But like a pp said, take an annual reading to keep an eye on it and put it out of your mind its OK for now.

Just chipping in that I’m the same. Once I realised that my blood pressure was normal when I was calm I could get calm much faster. I had to do 3 x per day for 14 days. Now I check it now and then and it fine (or just before a go appointment so I can say ‘I’m white coaty so took it before I came and it’s…they just nod).

Does anyone know whether anxiety can also raise the bottom number?

Bumping

I get my blood pressure taken annually because I'm on the pill. I have to take a reading twice per day for a week at home as the readings by the nurse are always high.

@franglais123 I've just had the exact
situation you describe. Had to calm down and then consistently got ok readings averaging 121/82 across 9 readings. But for a minute or so before that was getting 138/93.

Very keen to hear more views on whether this is white coat?