Glossary of terms related to hypertension / high blood pressure.

Arterial Hypertension – also just called “hypertension”, refers to a condition where blood pressure is elevated above normal. Normal is usually quoted as below 120/80.

White coat syndrome – a condition where an individual has elevated blood pressure at the doctors office, yet has much reduced / normal blood pressure at home.

Hypertensive emergency – a severe hypertension that impairs proper functioning of the body’s organs. Requires medical treatment to aggressively lower blood pressure.

Exercise hypertension – is a rise in blood pressure in response to exercise. This does not affect everybody, and in healthy individuals, we would expect to see a small drop in blood pressure during exercise due to improved blood flow.

Malignant hypertension – chronic high blood pressure (> 240/120) resulting in organ damage, especially the eyes, kidneys, brain and lungs. Malignant hypertension is accompanied by swelling of the optic disk.

Pulmonary hypertension – is an increase in blood pressure in the pulmonary artery (carrying blood from the heart to the lungs) or vessels in the lungs. The right side of the heart is put under pressure, and one of the common symptoms is shortness of breath and chest pains during exercise.

Renovascular hypertension – also called “renal hypertension” refers to the kidneys. This is caused by a narrowing of the renal arteries (carrying blood to the kidneys), reducing blood flow to the kidneys, which respond by sending out signals to the body to raise blood pressure. Renal hypertension is a secondary form of hypertension (which just means that we know why it happens).

Systolic pressure – the peak pressure in your circulatory system when the heart contracts. When the heart beats, blood is forced out into the aorta, increasing the pressure.

Diastolic pressure – The lowest pressure in your circulatory system, which occurs during the resting stage of the cardiac cycle (heart is resting between beats).

You may suffer from white coat syndrome.

A true story

I went to my doctor and was told I suffered hypertension. My blood pressure was 140/90. I was told I needed a lot of medical checks – weekly blood pressure readings, blood tests to check for cholesterol, thyroid problems etc, and urine tests, I guess to check for protein (which are normally not present in urine, but can be under extremes of pressure).

For my first weekly blood pressure check, I turned up on time for my appointment only to learn that she had gone off for lunch. Now, I am a patient man (no pun intended), but was not going to wait for her to return. I decided to go to the Pharmacy to get my blood pressure checked.

To my disappointment, my blood pressure was 140/100. The pharmacist asked if I was on medication. I was not, and did not want to be. I went home and did some research on the internet. I learnt about a phenomenon called white coat syndrome which made a lot of sense to me. The mere act of going to a doctor (white coat) made you nervous and increased blood pressure.

Well, the recommendation on the internet was to get a home blood pressure monitor. I bought one which had a cuff that went around the wrist, but found it inaccurate after checking at the pharmacy, so bought one that used an upper arm cuff. After getting it checked for accuracy at my doctors, I started taking my blood pressure at home on a daily basis.

To my amazement, my blood pressure during a typical day ranged from 130/90 to 110/65.

Certainly my blood pressure was not always high, and very rarely as high as it always seemed at the doctors office.

I now had it in my power to change my diet and monitor my blood pressure changes.

Giving up smoking cigars had a dramatic effect on my blood pressure. In addition, increased water intake to 3 litres or more a day, and decreased caffeine to 1 cup of coffee a day (I drank decaffeinated after this first one). Today, my blood pressure averages about 124/78. That’s normal.

Conclusions about white coat syndrome

Certainly my blood pressure at the doctors office was always higher than when measured at home. I have no doubt that white coat syndrome is a very real problem, and one I myself suffer from. I highly recommend you buy a home blood pressure monitor and check your blood pressure at home. Some doctors recommend this as a way of knowing your true blood pressure. Plus you can check what effects your lifestyle have on your blood pressure. This is the only way I have found to find an accurate measure of my blood pressure, while avoiding the elevating effects of white coat syndrome.

There is a suggestion that if you suffer white coat syndrome, it may indicate that your hypertension is linked with stress. Going to see the doctor stresses you and your blood pressure increases. If this is true, then just because white coat syndrome is responsible for your elevated blood pressure, it does not mean you are fine. You should continue checking your blood pressure at home, and also try to reduce stress levels in your daily life. Relaxation and meditation on a daily basis can help with this.

If you found this article about white coat syndrome interesting, you may be interested in learning more about diet changes that can help reduce your blood pressure.