Two things.
1- Get a good quality home monitor, not one of the cheap ones.
2- After keeping a record of your readings to show your doctor, also take your home monitor with you to the appointment so they can compare the reading on it and on the doctor’s monitor.
I agree that a second reading is almost always lower than the first. Ask the doc to take a second reading after a few minutes.
My BP is usually higher at the doctors office…but it’s still pretty low.
Mine REALLY was high before I had my wisdom teeth pulled…yikes. But the oral surgeon said that is the case for almost everyone…and he had my medical,records…so he knew my BP was usually not that elevated!
I agree with getting a home monitor. I also recommend learning to meditate. I always close my eyes and deliberately imagine my heart slowing down before they cuff me and my blood pressure is lower now than when I was in my 20s.
This is exactly my situation.
Also, I try to resist having my meds or dosages changed based on a single elevated reading. For example, I may have five consecutive normal readings, and then after just one spike, the doc sometimes starts talking about making alterations. I usually convince him to wait until I have a series of high readings before shaking things up.
I agree with others that you should take your bp at home and keep a log of it.
If your blood pressure is always normal at home, and only high at the doctor’s office, you should feel perfectly comfortable telling your doc you are not going to go on blood pressure medicine (should he pressure you to do so).
After doing biofeedback a few years ago, I learned I really can affect my heart rate and blood pressure by consciously thinking about it. As soon as I sit down in the doctor’s office, I take long, deep breaths and think, “Slow down, slow down.” It works for me. For people with a Fitbit that reads your heart rate, you can try this exercise. It’s really surprising!
I have a really strong “flight or fight” instinct which kicks in big time at doctor’s offices. My normal bp is about 110 over 60, and you give me a cup of tea and put me in the doc’s office and I’ll throw a 160 over 110 easily.
So… the best way for me to get a good reading is NOT to drink caffeine that day, and to have your doc’s nurse take your BP at the END of your appointment, not the beginning.
I also use an app on my phone while I’m in the waiting room that is supposed to help to relax you, but really, I may as well be Alexander going into battle astride Bucephalus with my hair on fire for a PAP smear for all the good it does me.
Once I get through it, though, hey, I’m cool as a cucumber and I throw good numbers.
The only gentle warning I’d give you all is to be mindful of your age and of the fact that it you are spiking high pressures in your doctor’s office, the likelihood is that you are spiking them in other stressful situations. I’m another one whose blood pressure is normal at home when I’m relaxed but who definitely has much, much higher readings in the doctor’s office. I am sure I’m also experiencing blood pressure spikes while stuck in traffic, when late for meetings or appointments, when going into the dentist. Given my family history and the fact that I’m in my 50s, I made a decision to start a low level dose of blood pressure medication. I’m feeling pretty darned good these days.
I take a very low dose BP med. But I would really love to get off it. When I increase my biking mileage, I get closer, but as of now, I still need a bit.
Invariably mine is higher when the female nurse takes it at the beginning of the appointment, and lower when the male doc takes it later. I guess women make me nervous. I need to test this hypothesis with a female doc or male nurse!
I just experienced the reverse. My BP is always normal. Went last Saturday for routine exam. My BP was 104/62, lowest ever. Went to the gym after and got lightheaded lifting weights. All afternoon, got lightheaded standing up. This happens when I donate blood, and it dawned on me that they took my BP after drawing blood for my blood test.
They take my BP right after they weigh me. How would it NOT be sky high?!?
This can work both ways. The first few minutes I relax, but if they are running late and keep me waiting for 45 minutes or more, the BP tends to soar. But that waiting problem is a topic for another thread!
@stradmom did you know you can refuse to be weighed, and I don’t mean making a big deal, you can just say, “I’d rather not” and they don’t. I monitor my own weight regularly, along with my exercise etc., I resent having to be weighed and enter into a permanent record a weight that does not represent my norm if it’s a bad day/week/month & it’s silly of me to put off going to the doctor just because I don’t want to get on the scale. I am well within the normal range and over the past 25 years I have a range I pretty much stay in, I know where I need to be & I know what I need to do to be there; I also know when there is a season that I don’t work quite so hard and 5# does creep on and I prefer not to document that.
Since I work in the insurance industry, I might be a bit more paranoid about what’s in my medical records than most people 
^^^^You can refuse just about anything related to health care. And I agree with the above about hating being weighed every time you go to a provider; it’s not always relevant. However, it can be very relevant, depending on the condition.
Many drugs given during surgery and during emergency situations have weight based doses. It’s best to go ahead and get weighed if you are going to have general anesthesia. Coming in with a cold or a sprained ankle, not that important.
A symptom of some things like cancer can be an unexpected weight gain/loss.
You can also have them weigh and not just tell you if you don’t want to know.
Right and if you have sucky insurance they want to see documented evidence of things like weight loss before they will approve necessary diagnostic tests. In my experience you can’t always just say, " I’ve had unexplained weight loss"; sometimes they need to see it in the medical record to justify certain tests or treatments.
And anyway, at the very most, the bloating, heavy clothes, and Doc Marten combat boots you happen to be wearing at one appointment as compared to another will add maybe 10 lbs. Likely much less. Why would anyone care about that on their medical record? That’s a sincere question!
^^^I’ve been known to remove earrings and my watch before being weighed. I wear light weight clothes and sandals I can easily remove. 
Completely crazy, I know.
I wouldn’t like to be a simultaneous translator where @MotherOfDragons is saying things like this:
Why are you concerned about 5 pound swings being in your medical records?