Nervousness can distort BP reading
Dear Dr. Gott: Whenever I go to my family physician, my blood pressure is high. In any other place it has been normal (Red Cross blood donations, the gynecologist, the school nurse, etc.). He has said maybe I have “white coat syndrome” and has let it go. However, at my last visit, again it was 147/85, and he said he must treat what he sees, so he wants me to go on a low-dose blood pressure medicine. (I believe he mentioned Altace.) He took it a second time, and it was still high. I do have a family history of high blood pressure. I have had our school nurses take it every day, and at different times of the day, since then for two weeks, and it has been fine (120/40). I walk seven to eight miles a day at a fast pace, go to the gym three times a week, bike with a group of women for several hours every Sunday and swim a mile once a week in the winter (every day in the summer), so I get plenty of exercise. He also wants to put me on cholesterol medicine because it is high (250). My good cholesterol is OK, but my bad cholesterol has gone up since I went off my Premarin. I can understand the cholesterol medicine, because my dad died at 60 from hardening of the arteries, but I’m a little unsettled about the blood-pressure advice. He has also recommended a baby aspirin daily. I am 56 years old but somewhat overweight, even with all that exercise. Any advice?
Dear Reader: Because of apprehension and nervousness, many people suffer from “white coat hypertension” – high blood pressure in a physician’s office. Such people do not – repeat, do not – have true hypertension. If your blood pressure is normal in other environments, as it appears to be, you do not need treatment. This is the reason why many authorities urge out-of-office monitoring, which provides a more accurate assessment of what your blood pressure really is.
Discuss this with your doctor, who might be willing to compromise by having your pressure taken once or twice a week by the school nurse. Or he might conclude that you should purchase a do-it-yourself blood pressure machine and monitor your pressure at home. If your blood pressure rises and stays high, you will need therapy. But if it remains low, no treatment is necessary.
To give you related information, I am sending you copies of my Health Reports “Hypertension” and “Understanding Cholesterol.” Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.