White coat syndrome : Hi all, I just... - Early CKD Support

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White coat syndrome

Hul1 profile image
Hul1
27 Replies

Hi all, I just thought I’d share something with you all about high blood pressure. For those of you who go to your GP /doctors to have it taken I would recommend you get a blood pressure money for home use .

Last time I visited my Gp it was 157/70... two weeks before that 166/90.... I was realy shocked as I have always had good blood pressure . So anyway ... I was suppose to be fitted with a 24 hour monitor to see what my blood pressure was like through out the day ( never did get the appointment) anyhow I decided to go and get myself a BP Monitor .

First time I tried it - it was still 166/90 !!!... I soon relised I was so anxious about getting a good reading ... so I calmed down - just sat for 2 mins breathing deep breaths ( not to deep just so I relaxed ...took a reading (s) throughout the day and my avareage reading was 138/82.

I’ve just took my latest reading - 127/73

Yes I suffer greatly from white coat syndrome!!

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Hul1 profile image
Hul1
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27 Replies
Jonquiljo profile image
Jonquiljo

Yes, my experience exactly. My Dr's don't believe me - even though I bought 3 different BP monitors and find that they all read the same when I am home.

When you think about it, you go into an examination room, usually a technician or assistant throws you into a chair and has you putting a cuff on before you even know what is happening. Taking BP is supposed to be on bare skin of arm at heart level (lots of Dr.'s don't do that), done in quiet with 2 minutes of relaxing, you're not supposed to talk, and your feet need to be firmly planted on the ground.

It's not supposed to be done in a wrestling match!

Hul1 profile image
Hul1 in reply to Jonquiljo

Spot on what you say - when I go into the doctors- it’s excactly what you describe - even chatting to you while you get your pressure done .

Jonquiljo profile image
Jonquiljo in reply to Hul1

Even worse ... 9 out of 10 doctors offices will totally ignore what your blood pressure is. If you have 160/100, they will write it down and not even tell you.

Stevo99 profile image
Stevo99

Makes you wonder how many people are wrongly put on blood pressure meds

B0xermad profile image
B0xermad in reply to Stevo99

Been on them 2yrs ,just came off for 6mths as a trial

Bunkin profile image
Bunkin in reply to Stevo99

I know that I take mine manually at home and it’s usually good. The automated bp cuffs are just not as accurate but of course that’s what all the doctors have now.

seabreezegirl profile image
seabreezegirl in reply to Bunkin

As a retired RN I like the old pump up ones . But you must have very good hearing to use them or you will MISS the first and last sound that you need to record.

B0xermad profile image
B0xermad

Me too , I did the same thing, bought one from Lloyd's was 176/80 and this morning 124/72 .panic about rushing about to get to the doctor no wonder it goes up

citronc3 profile image
citronc3

That's all very well! Most people become aware they have blood pressure. Symptoms include headaches, maybe a feeling of pain down right arm, periods of over activity followed by very low energy, breathlessness and more. It is wise to go to a G.P. then and get a diagnosis. Most people will have an near normal B.P on rest. That is why a 24 hour monitor test is good. Testing at rest and activity. Why risk a stroke or heart attack especially if there is a family history

citronc3 profile image
citronc3 in reply to citronc3

P.S. Imeant to say pain down left arm

Hul1 profile image
Hul1 in reply to citronc3

I don’t agree with your statement- most people DONT know they have high blood pressure- hence why it is called “ The silent killer” .. lots of my friends and family have High blood pressure and were totally unaware - no symptoms whatsoever . I would always recommend visiting your Gp .. but if like me you had normal good pressure throughout your life - and all of a sudden rockets from what it usually is - go do what many do - get a BP monitor for home use. Also I mentioned to my doctor I still had not got a appointment for me having a 24hour monitor fitted - he told me to - that these can give false readings as you are aware when your pressure is been taken and so therefore become anxious...

citronc3 profile image
citronc3 in reply to Hul1

Maybe I should have said A number of people become aware.

Sally10255 profile image
Sally10255

I am so lucky to have an amazing doctor. I write mine down for a good 2 weeks before appointment, then it is taken as I first check in, then he takes it when we are done:)

Bunkin profile image
Bunkin

I do too! I have to tell them that every time!!

lowraind profile image
lowraind

I only have a problem when I have an appointment with the nephrologist. As I have been thinking about this, I have realized that they usually rush me into the office, have inexperienced help taking it and do not follow proper procedures, which are (taken from

Harvard Health Publishing):

• Don't drink a caffeinated beverage or smoke during the 30 minutes before the test.

• Sit quietly for five minutes before the test begins.

• During the measurement, sit in a chair with your feet on the floor and your arm supported so your elbow is at about heart level.

• The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.

• Don't talk during the measurement.

• Have your blood pressure measured twice, with a brief break in between. If the readings are different by 5 points or more, have it done a third time.

RickHow profile image
RickHow

As you see we all experience this. Me too. I go to several doctors of different specialties. They all take it incorrectly, except my cardiologist. All the others do as Jonquiljo wrote. You sit in a waiting room for a while. Anxious. You get called in. You walk a distance (one of my doctors it is a long distance) to an office. Before the office you are stopped and put on a scale. Then you are put on a table and within 30 seconds the cuff is on and the blood pressure taken, all the while why the nurse is asking you "are you medications the same", "you are here for regular appointment", "how have you been". My cardiologist makes the nurse wait five minutes before taking the bp. She asks questions first. Then we sit 5 minutes in silence (she does paper work), then the bp. And those results always match measurements I get at home.

Jonquiljo profile image
Jonquiljo in reply to RickHow

You just made me laugh - and I needed that. Anyway, MOST Dr.'s don't do anything with the numbers if you have high BP. They just write them down. They don't want to talk this over with you - at least in the USA - because Dr's only get paid for doing one thing in an appointment. If you are there for headaches, they can't deal with the headaches and HBP. What nonsense!

I personally recommend (these are USA models, but probably sold throughout the world) an Omron model BP786N blood pressure machine. The cuff fits well and the accuracy is great. The machine can be set up to take 3 readings in a row with 60 seconds wait time between each. The machine will then average all three readings to give you a more accurate assessment.

The machine can be then set to download your reading to your phone via Bluetooth. Then you can bring your phone into your Dr. and show them all your BP readings.

Hul1 profile image
Hul1 in reply to Jonquiljo

I have the omron m3 comfort .

It logs your data ... - someone pointed out to me on another thread apps you can get to log your data in to which I am doing. Like the sound of your one -specially as it has Bluetooth and just transfers your readings to your phone 👍

Jonquiljo profile image
Jonquiljo in reply to Hul1

The bluetooth is great. I just hand a Dr my phone and they can check out my numbers quickly. It designates your stage of hypertension by the “new” system. Since I am 65, its hard to get my bp into the normal range. The new ranges are really strict! I think it puts a huge proportion of people as having a hbp problem - similar to CKD.

RickHow profile image
RickHow in reply to Jonquiljo

So glad to read this post. I have been thinking recently of getting a new bp "machine" for home. Mine, also an Omron, is getting a bit on the old side, and does not have such features as multiple memory, etc. There are so many I have been casually looking at. I will definitely check this one out. Thanks for the tip.

Jonquiljo profile image
Jonquiljo in reply to RickHow

You can find it on Amazon. The machine is impressive.

Hul1 profile image
Hul1

I think it was Rickhow who pointed white coat syndrome to me in another thread ...

I’ve been thinking about Bp today ...

So I consider my self relatively “fit”

Excersising at least 5 days a week 40 mins on a stage - usually kettlebells - martial arts - cycling

Weights ...anyhow today I took my BP while training - I was totally tracing flat out - kettlebells - reading was. 197/103 - pulse 143

So 50 mins after I’d finished - I spent 2 mins relaxing - reading was

136/85- pulse 78.

Now interestingly - I have a mindlfullnes app. I played and listened to it for 3 mins took my BP again and in that 3 mins it came down to 128/84- pulse 55.

So .. here is my thinking -

The less stressful we are - the better reading we get . So ... many folk are on medication due to high BP .. through stress .. so do we need to learn better on how to manage stress - rather than a quick fix with medication . Of course we are all different- some folk are anxious and stressful and they find it realy hard to manage stress

While others may ... do better learning how to relax more - meditation etc ... just a thought ...

McLabhran profile image
McLabhran

My sister recommended me getting a BP monitor (They are reasonably priced these days). It is said that our blood pressure varies throughout the day and depending on our state of being can also affect the reading (e.g.. you get a tax bill from the IRS saying you owe them $75,000!) They say to read your BP first thing in the morning before any kind of activity (before brushing teeth, breakfast). Do this for a few days so that you can see what your average BP. Everyone has their own average. My sister tends to have high BP and yet, I tend to have low BP. That is why there is a medical range of BP testing. If I am at the doctor's office, they always take your BP, but I have them wait to take my BP because I just arrived and therefore in "active" mode which raises the blood pressure. Some medicines raise BP..even headache pills. Read the labels.

RickHow profile image
RickHow in reply to McLabhran

Here again we share different advice from different doctors. My primary care and my cardiologist both say do NOT take the pressure the very first thing in the morning. IF I do then I should expect higher than average readings. They say when you wake up and get out of bed, get ready for the day, so does your body. It is waking up also. It is putting demands on your heart to increase blood flow to the body and brain. And this reading will be higher. It you want your worse reading of the day then this would be it. If you could take it when you first wake up, while still half asleep, lol, and not out of bed at all, this would give you the best "at rest" reading. Putting all that aside, I am advised that it is most important no matter when you take your blood pressure, that each day you take it at the same time(s). It would not be accurate to compare your pressure one day at noon, to another day at 7pm, for example. Do not take it without 3 to 5 minutes of rest. Be sure to not take it within 30 minutes after eating or drinking (especially coffee, tea, soda).

Kid-Ney3 profile image
Kid-Ney3

I too have white coat syndrome. What ever Doctor I go to my b/p is always high. When I have procedures done such as a colonoscopy it goes sky high and they have to give me medication to take it down. I was on losartan for 6 years and I stopped taking it. I have a feeling that is what gave me stage 3 ckd. When I take my b/p at home I always take it more than once. I usually comes down to a normal level.

seabreezegirl profile image
seabreezegirl

Reactive BP is what it is called .I used to have a doctor who would get mad at me that I am a bit not too much over weight .

So when ever I would go see him my BP would be up higher than normal.

Just take it at home when you are feeling calm

Write down ime and date AM , and PM for 14 days . Take this record to the doctor .

Darlenia profile image
Darlenia

Interesting thread regarding blood pressure. My hubby, a diabetic with a transplant, always has rather high blood pressure whereas mine is most often low. We've been told that the best blood pressure readers are the "pump up" ones - one referred to them as the "gold standard". Like most people, my hubby uses the Omicron model that records and stores blood pressure readings. When the Omicron showed high blood pressure readings on my hubby, a doctor asked us to bring it in to check against the "pump up" version and discovered that the Omicron did indeed inflate the numbers a bit for him. But it does okay with me. I wonder if muscle mass, placement and quality of blood vessels, etc. make a difference. Then, I also wonder if it's good to always take blood pressure in a calm, quiet environment when perhaps that's not one's "usual" environment. I say this because because way back in time, my pregnancy produced high blood pressure. Concerned, my ob-gyn told me to lay down and rest (which I never did routinely), and then recorded my blood pressure when it registered just fine. Well, the baby was born very underweight and struggling. A neonatologist later told me that I had untreated high blood pressure throughout that pregnancy that resulted in this outcome - my ob-gyn should have gone with the more active lifestyle readings. So, it's important, in my view, that blood pressure readings reflect your normal state of affairs. I recall a Canadian report that recommended everyone take three readings in a home setting (avoiding a medical setting) and then averaging them. Maybe that's a good thing to do rather than only relying on the "best" or the "worst" readings in doctor's offices. Anyway, these are just my meandering thoughts and observations looking back over time.

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