White-coat hypertension doesn’t require medicine – Dr. Paul Donohue

(Lubbock Avalanche-Journal) Dear Dr. Donohue: My husband has “white-coat” hypertension in the form of highly elevated blood pressure whenever he goes to the doctor for his routine checkups. He has a blood pressure monitor at home and checks his blood pressure at least once daily. The machine was calibrated twice by the doctor and was found to be accurate. His readings at home are always 120 or less systolic over 80 or less diastolic with the home machine, but can be 160 systolic at the doctor’s office. Does he need additional medication for his blood pressure?

Reactive hypertension — high blood pressure resulting from a situational rather than a medical source — is very common. When it’s the result of seeing the doctor (the “white coat” part), it can lead to overtreatment if not recognized. You and your husband have done exactly the right thing — bought and tested a home machine, and your husband regularly tests his blood pressure at home.

If the readings at home are consistently good and there are no other signs of poorly controlled blood pressure (the doctor may look at the back of the eyes, listen to the heart, check kidney tests or even get an echocardiogram to look for signs of damage from high blood pressure), then I would not recommend additional medication.

For others in the market for a home machine, home blood pressure cuffs that go around the upper arm, not the wrist or a finger, tend to be the most accurate. Definitely bring it in to the doctor so that it can be checked for accuracy. More blood pressure measurements mean better information for you and your doctor to decide about treatment.

Read More Medical Q and A from Dr. Paul Donohue >>

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