For most people, going to the doctor is usually a bit nerve-racking. But for some, the stress of a medical appointment triggers a temporary rise in blood pressure. If that’s the case for you — and if your blood pressure is normal at home and in other nonmedical settings — you may have what’s known as white-coat hypertension. Now, a large study suggests that people with this condition face a greater threat of heart disease than people whose blood pressure readings are always normal.
According to current guidelines from the American College of Cardiology and the American Heart Association, normal blood pressure is defined as less than 120/80. High blood pressure is 130/80 and higher.
“If your blood pressure goes up under the relatively nonthreatening situation of seeing a doctor, then what might happen if you’re cut off on the highway, or experience a challenging family or work circumstance?” says Dr. Randall Zusman, a cardiologist at Harvard-affiliated Massachusetts General Hospital.
Everyone’s blood pressure fluctuates constantly throughout the day. But people with white-coat hypertension may experience more frequent and higher spikes. About one in five people has the condition, which doctors typically don’t treat with medication.
The white-coat effect
For the study, researchers pooled findings from 27 studies involving more than 64,000 people in the United States, Europe, and Asia. Compared with people whose blood pressure was normal both at the doctor’s office and at home, people with untreated white-coat hypertension had a 36% higher risk of heart attack, stroke, and other heart-related events. They were also twice as likely to die from heart disease.
However, people taking blood pressure medication whose blood pressure still rose at the doctor’s office (a phenomenon known as the white-coat effect) did not have a higher risk of heart disease. The study was published June 10 in Annals of Internal Medicine.
According to Dr. Zusman, the findings lend further support for treating people with white-coat hypertension. Research suggests that the condition nearly always progresses to sustained high blood pressure.
What you can do
Treatment doesn’t necessarily mean taking blood pressure medication, however. “Losing weight, exercising, limiting salt, and not smoking are all associated with better blood pressure control. I certainly encourage people to do all those things, whether they have intermittent or sustained high blood pressure,” says Dr. Zusman.
Sometimes, even determined efforts to make these changes aren’t sufficient. If lifestyle changes aimed at controlling hypertension can’t bring your blood pressure down to a normal range, there are many safe, effective medications that can help.
Dr. Zusman advises all of his patients to use a home blood pressure monitor to make sure their treatment is working. “I also have them bring their device in and watch them take their blood pressure to make sure they’re using the monitor correctly,” he says. Doctors often suggest checking your blood pressure once or twice a day for a week or so right after starting or changing medications. After that, two to three times a week at different times of the day is a good idea, says Dr. Zusman.
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
Ecclesiastes 3:12-13 I perceived that there is nothing better for them than to be joyful and to do good as long as they live; also that everyone should eat and drink and take pleasure in all his toil—this is God’s gift to man.
Psalm 1:1-6 Blessed is the man who walks not in the counsel of the wicked, nor stands in the way of sinners, nor sits in the seat of scoffers; but his delight is in the law of the LORD, and on his law he meditates day and night. He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither. In all that he does, he prospers. The wicked are not so, but are like chaff that the wind drives away. Therefore the wicked will not stand in the judgment, nor sinners in the congregation of the righteous; …
John 14:1 “Let not your hearts be troubled. Believe in God; believe also in me.
John 16:24 Until now you have asked nothing in my name. Ask, and you will receive, that your joy may be full.
Psalm 34:8 Oh, taste and see that the LORD is good! Blessed is the man who takes refuge in him!
Isaiah 26:3-4 You keep him in perfect peace whose mind is stayed on you, because he trusts in you. Trust in the LORD forever, for the LORD GOD is an everlasting rock.
Galatians 5:22-23 But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control; against such things there is no law.
Jeremiah 29:11 For I know the plans I have for you, declares the LORD, plans for welfare and not for evil, to give you a future and a hope.
Luke 6:43-49 “For no good tree bears bad fruit, nor again does a bad tree bear good fruit, for each tree is known by its own fruit. For figs are not gathered from thornbushes, nor are grapes picked from a bramble bush. The good person out of the good treasure of his heart produces good, and the evil person out of his evil treasure produces evil, for out of the abundance of the heart his mouth speaks. “Why do you call me ‘Lord, Lord,’ and not do what I tell you? Everyone who comes to me and hears my words and does them, I will show you what he is like:
Matthew 5:3-10 “Blessed are the poor in spirit, for theirs is the kingdom of heaven. “Blessed are those who mourn, for they shall be comforted. “Blessed are the meek, for they shall inherit the earth. “Blessed are those who hunger and thirst for righteousness, for they shall be satisfied. “Blessed are the merciful, for they shall receive mercy. …
John 3:16 “For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.
Proverbs 16:20 Whoever gives thought to the word will discover good, and blessed is he who trusts in the LORD.
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