Late onset white coat syndrome

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BP Anon

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I have been experiencing some odd BP readings and not sure what to do about it.

Last year, I noticed that my blood pressure was getting high. I put on a bunch of COVID weight and hadn't been exercising much. Went to my primary care doc and was put on hypertension medicine. Got the letter and went to the AME - a new one since my previous one had passed away. Oddly enough, even though I was having normal blood pressure readings at home and with my primary care doc, I was still high at my AME's office (150/90), although within FAA limits, so he issued.

A few months later, I was having some side effects from the medicine while working out and went back to my primary care doc for followup. We agreed to go off the meds. Although my BP was elevated (130/85) doc agreed to no meds and exercise. Recently, at a dentist checkup, my BP was 155/95. Freaked me out a bit since my next AME visit is in a couple weeks.

I've been monitoring my BP at home the last few days (use a Beurer BM55) and almost every time, the first reading is high and then I'll hit the button to do another less than 30 seconds later and every one after that is around 125/80-85. WTF! It's like my body starts stressing as soon as the cuff inflates on the first run. Then after seeing the bad news, my body immediately relaxes.

It sure seems to me that the issue is primarily psychological, but the more it happens, the more freaked out/stressed I seem to get.

Anyone else experienced a similar reaction? Assuming it is psychological, any ideas on how to overcome the problem?
 
Take your BP twice a day every day for a few weeks. It will settle down enough to ease on through a physical. Try it, you'll see.
 
Yes, something similar is happening to me. The BP is creeping upward. Most noticeable at doctors or dentists. It was 145/79 recently at the doctors. But I just took it right now relaxed at home: 117/66. Used to be I didn’t have white coat hypertension, it would be 116/60 at the doctors. I’m not sure what’s changed but now I believe it was even 150/80 one time.
 
Mine spiked way up with weight gain last year I put on 50lbs from 1/2019 till last May when I started back at the gym right after I got the vaccine. In 2019 it had been 127/75 last year it spiked to 188/90. Since I have been going to the gym every day since May it's back to 127/83 now. Still have about 15 lbs to go get back to pre-covid weight eventually my goal is to get down see if I can get rid of my CPAP. Amazing how exercise really bring it down I had been taking my BP daily and noticed sometimes my Systolic was spiking up to 175/88 I thought something was wrong because it should be going down. What I didn't know was caffeine was causing it we just got a new espresso machine. I always take my BP on days I don't drink anything with caffeine.
 
Most doctors (and a lot of machines) have a lot of error potential and like left turning tendency on an airplane, these errors all tend to cause higher than actual readings.

I was quite surprised when my current AME did my BP with a regular cuff and actually used proper technique (over the past 40 years, I've only come across a couple of doctors and a small number of nurses who actually use the proper technique on BP measurement. TheAME says they don't believe in doing otherwise (which is good when the FAA uses a line in the sand measurement).

My BP was getting up there last year, but losing 50 pounds (and the incumbent exercise required to do that) has dropped my BP below 120/80 and my cholesterol and other lipid numbers have come back into line as well.
 
kell490 said:
Mine spiked way up with weight gain last year I put on 50lbs from 1/2019 till last May when I started back at the gym right after I got the vaccine. In 2019 it had been 127/75 last year it spiked to 188/90. Since I have been going to the gym every day since May it's back to 127/83 now. Still have about 15 lbs to go get back to pre-covid weight eventually my goal is to get down see if I can get rid of my CPAP. Amazing how exercise really bring it down I had been taking my BP daily and noticed sometimes my Systolic was spiking up to 175/88 I thought something was wrong because it should be going down. What I didn't know was caffeine was causing it we just got a new espresso machine. I always take my BP on days I don't drink anything with caffeine.
Click to expand...

Caffeine, I never thought of that!

https://pubmed.ncbi.nlm.nih.gov/18094346/
 
A number of years ago my doc had me lose 20 lbs, rigorously monitor my sodium intake, and do 30 minutes a day on the treadmill (or similar) to raise and sustain the heart rate. This worked very well as BP was creeping up. My BP also tends to be higher in the morning and if it is, caffeine will keep it elevated. I miss my morning coffee but it's an easy adjustment.

The other thing I learned was to get up and hydrate early (a bottle of water) and get on the treadmill (or similar) for my 30 minute workout. This will bring the BP right into line and it usually stays good the rest of the day. So far I take no BP meds. I may get to them sooner or later but I thank the Lord so far I'm completely medicine free ...
 
flyingron said:
Most doctors (and a lot of machines) have a lot of error potential and like left turning tendency on an airplane, these errors all tend to cause higher than actual readings.

I was quite surprised when my current AME did my BP with a regular cuff and actually used proper technique (over the past 40 years, I've only come across a couple of doctors and a small number of nurses who actually use the proper technique on BP measurement. TheAME says they don't believe in doing otherwise (which is good when the FAA uses a line in the sand measurement).

My BP was getting up there last year, but losing 50 pounds (and the incumbent exercise required to do that) has dropped my BP below 120/80 and my cholesterol and other lipid numbers have come back into line as well.
Click to expand...
Correct measurement technique is a pet peeve. I had more than one nurse try to take BP with the cuf on the outside of my shirt sleeve.
 
Rushie said:
Caffeine, I never thought of that!

https://pubmed.ncbi.nlm.nih.gov/18094346/
Click to expand...

I read to just wait 30 min as stated in that study 30 minutes is not really long enough at least from what I have seen did some experimenting caffeine really spikes it up. Also nasal spray like Afrin (Oxymetazoline) and decongestants like Sudafed. I'm sure there is a long list things that can spike it if one is border line want to avoid all that when you go get your medical.
 
flyingron said:
Most doctors (and a lot of machines) have a lot of error potential and like left turning tendency on an airplane, these errors all tend to cause higher than actual readings.
Click to expand...

This and a lot of those cute, young nurses like to use the small cuff because it is easier for them to handle, and the small cuff is too, well, small for my arm.

I will make the attendant wait for one minute while I sit still with no disturbances before taking my BP.

I will hold my arm at heart level to have my BP taken, and almost every nurse will try to push my arm down.

Dentist taking blood pressure.?? I have never had that experience except once when I had oral surgery.
 
https://www.healio.com/news/cardiol...MIqfGq3v7J8gIVMT6tBh2FOAZhEAAYAyAAEgJ0AfD_BwE

(readers digest version)

Having a full bladder can add 10 to 15 points to a BP reading;

Slouching, unsupported back/feet can increase a reading by 6 to 10 points. Those undergoing a BP test should ensure that they are in a chair with back supported and feet flat on the floor or a footstool;

An unsupported arm may result in a reading up to 10 points higher. Positioning the arm on a chair or counter will level the measurement cuff with the heart;

Wrapping the cuff over clothing is a common error that can add 5 to 50 points to a reading. Instead, be sure the cuff is placed on a bare arm;

An insufficiently sized cuff may cause a reading to be 2 to 10 points higher. Talking to a health care provider will ensure a proper fit;

Sitting with crossed legs could increase a BP reading 2 to 8 points. It’s best to uncross legs and ensure feet are supported.

Talking, including on the phone, can add 10 points. Staying still and silent during the exam will ensure an accurate measurement.
 
So the other day relaxed and in the evening it was 117/66. I took it this morning 2 hours after 14 oz of coffee and it was 128/64. Just now I had a second mug (14 oz) of coffee and it is now 130/76.

It appears that immediate consumption of caffeine affects the diastolic. But this is hardly a scientific dataset.
 
Rushie said:
Just now I had a second mug (14 oz) of coffee and it is now 130/76.

It appears that immediate consumption of caffeine affects the diastolic. But this is hardly a scientific dataset.
Click to expand...

Just checked mine after my second cup and it came up at 125/77 which is a high normal for me. At my age the doc says I should be under 140/90 but I work to keep away from those kinda numbers. IIRC the FAA limits for BP are 155/95 but that seems to be pretty generous (and dangerous) to me.
 
Daleandee said:
Just checked mine after my second cup and it came up at 125/77 which is a high normal for me. At my age the doc says I should be under 140/90 but I work to keep away from those kinda numbers. IIRC the FAA limits for BP are 155/95 but that seems to be pretty generous (and dangerous) to me.
Click to expand...

Agree!
 
Start breathing deeply as soon as you arrive at the doctors office, and make a conscious effort to continue until the blood pressure test is over.

I find that I can drop my pressures by about 20 every time that I do it. It also produces pressures that are more similar from one test to the next, if you do a series of checks.
 
Daleandee said:
Just checked mine after my second cup and it came up at 125/77 which is a high normal for me. At my age the doc says I should be under 140/90 but I work to keep away from those kinda numbers. IIRC the FAA limits for BP are 155/95 but that seems to be pretty generous (and dangerous) to me.
Click to expand...

I agree I wonder if those numbers the FAA uses is from many years ago when it used to be 140/90 and under was normal. Looking at Webmd 140 or over Systolic, or over 90 Diastolic is Stage 2 hypertension. 2003 the numbers were lowered to 130/80 and below was normal.

https://newsroom.heart.org/news/high-blood-pressure-redefined-for-first-time-in-14-years-130-is-the-new-high#:~:text=High blood pressure is now,occur at those lower numbers.
 
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