When Is High Blood Pressure Normal?

Should you worry about high blood pressure (BP), once the level exceeds normal recommended guidelines? According to the American Heart Association, a normal reading is any value just below 120/80 mmHg (millilitre of mercury). Slight variations above and below this value is natural. But what of persons who commonly display a condition called “white coat syndrome,” do they have due cause to be alarmed?

A person diagnosed with “white coat syndrome” or “white coat hypertension” is your typical hypertensive patient. These persons display readings significantly above normal values and only in the presence of a doctor or nursing staff, hence the term “white coat.”

As much as 25 per cent of the population in the United Kingdom are affected by this phenomenon. That is approximately 2 million people who may be taking drugs to lower a non-existent condition with serious implications. Also, anyone can develop this phenomenon. The symptoms are often seen in the late 30s and up, and in pregnant women.

Although variations in blood pressure above and below standard guideline are no indication of a problem, with white coat syndrome a doctor is often unable to establish a baseline reading. A person’s baseline reading represents the average value, taken at similar times each day, for a period of 3 days.

Understanding the Factors that Influence Blood Pressure Changes

BP is dynamic therefore readings will fluctuate depending on the time of day, food intake, emotions/hormone changes, gender, race.

• Diurnal (happening daily): morning and night time pressures are usually the lowest. The highest values occur during the mid-afternoon.
• Food: caffeinated beverages and salted products trigger increased blood volume and should be avoided just before a test.
• Emotions/hormone changes: anxiety, stress, pain, and other emotional reactions to a person’s surroundings will likely increase the pressure. Hormone alterations are seen more readily in females, decreasing their blood volume during menstruation or increasing it during pregnancy.
• Gender: After puberty men tend to have higher readings. In women, after menopause, higher levels of pressure may develop.
• Race: The tendency for people of African descent to have higher rates of hypertension is believed to be linked to genetic and environmental factors.

How to Manage “White Coat Syndrome”

White coat syndrome is caused by anxiety which triggers the “fight or flight” (adrenaline rush) response causing an elevated BP.

In order to diagnose white coat syndrome, individuals measure blood pressure outside of clinical settings. Patients are usually asked to use a home device at set times of day to get a baseline reading.

Studies have shown that persons with white coat syndrome eventually develop hypertension. Stress management is usually recommended. Relaxation techniques that include hydrotherapy, meditation, and hypnosis have all been postulated as effective management tools.

A false reading of high blood pressure can create problems just as severe as actually having the disease. Knowing the facts and taking control through home monitoring and lifestyle changes will reduce concerns related to this condition.