Do you have, or know someone who has, White Coat Syndrome (blood pressure much higher in doctor’s office than it normally is)? How can you establish the truth of what your blood pressure really is such that your doctor - and you - will fully believe it?
Get a BP monitoring cuff for home use, take your BP every day around the same time, keep a log of it, and share it with your doctor after a couple of weeks.
You can get an at-home blood pressure monitor. I am using one now as I just started a new heart medication that makes my already low blood pressure even lower.
I use an electronic cuff that was recommended by my doctor. I’d suggest discussing this with her/him.
I think white coat hypertension is actually more complex than the normal explanation. My blood pressure runs high, and I have a monitor that I use here. Every time I use it, the first reading is higher than the readings taken afterwards. I think it is some variation of “flight or fight” reaction, related to anxiety and adrenaline. I can usually get a series of steady readings after sitting still and taking 5+ or so readings that are about 10 points lower than the first reading. Sometimes the stabilized readings are 12-15 points lower.
In any case, get a good home cuff and use it a bunch and you’ll get an idea of where you stand.
Buy an electronic blood pressure monitor and measure it yourself at home. You can get a reasonably reliable/accurate one for ~$30. You can take regular readings (daily, weekly, etc) and have pretty good confidence in the results.
I told the doctors and nurses this “white coat hypertension” explanation while I was delivering my first D via cesarean section. She was in fetal distress as her head was stuck on my tailbone, but the monitor was picking up my very fast heart rate. I agree with @dadx that it was related to adrenaline and stress, but it isn’t “fight or flight” for women- it is tend or befriend.
What dadx said. Get a home BP monitor. We have a Microlife from Costco. Mr. took it to his doc’s office to compare to the one the nurse is using there. It was pretty accurate.
Take 4 readings, toss the outlier, and average the remaining three.
Or put the cuff on, ask someone to bring you a purring cat, let the cat settle in your lap, and then hit the start button. Cats do lower BP, as Mr. discovered.
Thanks. I’ve had a home blood pressure monitor that works on the wrist, and both that and an upper arm based one that I borrowed last year indicated (when I did an exercise of 84 readings over a week) a blood pressure of around 127/76. It sounds like you guys believe in these devices. I hope the doctor I’m going to see again after a 155/95 reading in his office does.
Ask the nurse to take your BP several times throughout the appointment. Any chance you come to your appointments dehydrated?
Caffeine can and will also elevate BP readings. There is some evidence I read that “white coat” elevated blood pressure readings may be an early warning that you will need to pay more attention to your BP. Can’t recall the citation offhand.
Agree with the Costco automatic blood pressure machines that will keep your most recent 90 or so readings, I believe. Have heard from my staff and others that wrist auto tests are less reliable than cuff on the arm.
Agree with @BunsenBurner. My doctor will always take a reading again at the end of the appt. if it seems higher than usual at the beginning. Many of us hate doctor’s appointments so it can have an effect. Does your doctor’s office do that?
My blood pressure has always been optimal. I was particularly stressed out about one dr appointment. When the nurse took my blood pressure, it was in normal range but much higher than my normal. The nurse asked “stressed out today?” So I definitely believe in the white coat effect
I have very very low BP, at the doctor’s office, even for a mundane check up, it’s quite normal; I can only imagine how people with normal BP appear high at their physician’s . I like the wrist monitor for my husband, taken over time it is pretty consistent and I take mine at the same time.
Here’s an article discussing white coat hypertension.
I have white coat syndrome. I explained this to my doctor at my last visit. He was cool with it. Although…he did take my blood pressure three times. 150/100 was my best reading.
After the visit, I went home… An hour later… 115/70.
I don’t know why I have white coat syndrome. I think it is because I had an irregular heartbeat. I fainted. I go to the hospital. The cardiologist said, “If the irregularity doesn’t stop, I am going to have to put in a pacemaker”.
I said, “no fing way”, except I didn’t say fing. 
I told the cardiologist he was freaking me out and if I went home the irregularity would stop.
After a couple of days, the cardiologist said he couldn’t find what was causing the irregularity. I was sent home. After an hour at home, the irregularity stopped.
I took a beta blocker for about 6 months after that hospital stay. Stopped it after 6 months. I haven’t had an irregular heartbeat since an hour after I left that hospital. I think this was 12 years ago.
I think the threat of the pacemaker has caused my white coat syndrome but I have never discussed this with a therapist. 
Make sure you have quality BP equipment at home so you aren’t getting a bad reading consistently.
Also, try showing up early at the doctor’s office and giving yourself some time to sit and chill with a book (unless your doctor does that anyway because the office is always behind schedule. Mine is very timely.)
My White Coat Syndrome started one day about 10 years ago. I was seeing a neurologist for some odd symptoms (turned out ok). It was an extremely hot day and I could not find parking in the parking garage. I finally went a few blocks away and ran to the appointment. I rushed in hot and sweaty. The nurse took my BP right away and it was, for the first time in my life, high. Very high (thinking 160/90). The thing is that she GASPED!!!
And so my White Coat stuff began.
Just two days ago I had a 130/80–first time a normal reading in a doc office. Normally I am about 150/90.
I have no idea why I was pretty ok that one day. It does help to make sure they do a manual test and tell you to have your legs down and testing arm up and other at rest and to breathe.
But I agree about the home test and to record as most doctors do understand this sydrome.
That said, dear dear H saw my home reading a few days ago at 134/80 at a first reading and went on to tell me that it needs to be 120/80 (or so). :-@ :-@ :-@ .
He was informed that he needs to knock that off–best reading for a first reading I have had in 10 years. Yeah for me!!!
I did have a very bad experience 3 years ago at work and had the symptoms of a heart attack. BP was
220. ER. Crazy night. The only explanation ended up being a serious adrenolin rush due to the situation.
Settled down and has never happened again.
I purchased a monitor and took it to my visit so we matched up the reading on the doctors machine and mine. We were about the same on both.
My doctor checks my BP twice; first the nurse gets the number when I arrive then the doc takes it again when he comes in for the exam. By then, I was sitting more than a few minutes waiting for him. My BP is a lot lower in the second reading, sometimes as much as 20.
I have white coat syndrome. My BP is always higher when the assistant takes it at the beginning of the appt than when the MD rechecks it later. It still tends to be even lower at home. I have a BP monitor to use at home. Doctor recommended one that goes on the arm vs. the wrist, since she felt that it was more reliable.
Getting early to the doctor’s office doesn’t work for me because I get annoyed when they run late so I’m waiting even longer than expected.