White coat syndrome: symptoms, causes, and what to do about it

It is common to go to our nearest mental health center to have a routine check-up. There the doctors and nurses will take our vital signs, such as temperature, pulse, respiratory rate and also blood pressure.

It happens to some that, when they enter a hospital, they get sick, very nervous. They are so nervous that their blood pressure momentarily rises so much that the values ​​are those of hypertension.

This phenomenon is known as white coat syndrome. and it is very important to take it into account when diagnosing and treating patients, since it implies the risk of treating hypertension that, in reality, is not real.

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What is white coat syndrome?

White coat syndrome or white coat hypertension is a condition in which a transient increase in blood pressure occurs when the patient is in a healthcare environment, such as a hospital, clinic or outpatient site, with “white coat” professionals. This condition is believed to affect about 30% of the general population.

In the spaces that are given, it is common for basic vital signs to be measured, precisely to be able to detect if there are any health problems, such as temperature, pulse, rate, and pressure arterial.

At first, the white coat syndrome may seem unimportant and even somewhat humorous. It represents the classic situation of a patient, male or female, who is so nervous about being in the hospital that his nerves send his blood pressure skyrocketing. However, what is not funny is the risk of it being treated as hypertension which, in reality, is just a one-off thing.

If the doctor or nurse does not take into account the possibility that the patient suffers from white coat syndrome, a false positive for hypertension can occur. It is true that, normally, that patient could have hypertension and will need to take medication, but what if not? What if his levels are normal when he's away from the hospital? Then there is a risk of medicating a patient who is healthy or giving him higher doses of medication than he needs.

Typically, people with white coat syndrome are normotensive, that is, their normal blood pressure levels blood pressure are not elevated and, therefore, do not require any treatment for hypertension, because they simply do not have that trouble.

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Causes

The explanation behind the appearance of this curious phenomenon is that there are people who feel very uncomfortable when they are in sanitary spaces.

They interpret the place as a threatening environment, although they rationally know that they are safe and nothing has to happen to them. However, your brain does not see it that way, and sends an alarm signal to the entire body. This causes an increase in several vital signs, including those precisely measured by doctors and nurses, such as blood pressure.

In some patients, having their vital signs taken by a doctor causes them to increase on their own. Naturally this depends a lot on the negative predisposition of the patient, if you are more or less nervous than normal, or if you perceive the hospital as a place where bad news is received and you worry about what your doctor may tell you.

Other factors that influence the appearance of white coat syndrome are:

• Anxiety
• Depression
• fear or fear
• Fear of death or thanatophobia
• Hypochondria
• Reaction to the expertise of the specialist (doctor or nurse)
• Stress
• negative environment
• Poorly calibrated blood pressure instruments

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Diagnosis

White coat syndrome is diagnosed when the doctor or health care professional realizes that the patient's blood pressure values ​​taken in the health center do not correspond to the usual ones. That is, if the physician finds that the patient's blood pressure is often lower when he or she is not in the hospital, consideration should be given to possibility that the patient was very nervous when this constant was taken, so much so that it was identified as a hypertension.

Taking into account the characteristics of the syndrome itself, it may seem difficult to know if the patient has this problem. The reality is that it is quite simple. What should be done is that the patient measures his blood pressure at home, following the advice of experts. If he does it at home, calmly, without noise and at a comfortable temperature, he is more likely to get blood pressure values ​​more in line with reality, regardless of whether they are healthy or indicative of hypertension.

If the levels at home correspond to those considered normal but those taken in the hospital are clearly much higher, it is quite likely that the patient has white coat syndrome or that the day he went to the hospital he was nervous about the fact that be there. He is a normotensive person, although the devices used by the doctor say otherwise.

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What to do and how to measure the tension well?

Finally, we do not want to close the article without clarifying some of the general recommendations for the correct measurement of blood pressure, whether it is at home or in the hospital environment. There are certain aspects that may seem of little importance, but which are precisely those that mark the difference between a false diagnosis of hypertension and a true one, caused by pressure problems real blood.

There are details that can cause blood pressure values ​​to be increased, the most obvious being take the measurement at a time of extreme nervousness or anxiety or if you are suffering from any type of physical pain.

It is recommended not to smoke at least half an hour before and not to drink stimulating drinks (coffee, tea, cola, energy drinks...). Sports activity should not be performed the hour before taking the blood pressure and it is very important to urinate before the test, because having the urge to urinate can alter the results.

These recommendations are useful both when the measurement is done at home and in the health center. Taking into account that pharmacies are health spaces where the time that the patient can stay in it is not so limited, unlike hospitals, it is advisable to do it in the usual pharmacy, trying to be relaxed and being able to repeat it when we wish

If after home blood pressure values ​​are normal, no treatment is required, although it is convenient to maintain a healthy lifestyle. Attention should be paid to food, which is healthy and balanced, not abusing salt and exercising with some regularity.