Like many people, Carol is anxious at the doctor’s office. She feels out-of-control the minute she walks into the lobby. As a result, she has suffered from “white coat syndrome or hypertension” for years, which is a temporary increase in blood pressure. The first time it happened Carol was concerned, but her doctor told her not to worry because one high reading was not a problem. Now, every time her annual physical comes around, she and her doctor discuss her blood pressure. It continues to be consistently high in his office and Carol is certain that her blood pressure goes up due to her anxiety in anticipation of the visit. Her doctor is not so sure, as he believes that white coat hypertension is a forerunner of real hypertension. They agree to disagree as Carol refuses to take medication for it anyway. Other factors can contribute to faulty readings. Carol’s blood pressure may not have been measured accurately during those early visits. Health professionals may not always use the best technique as they hurry through their day.
Carol can take control of her own situation. She can learn to take her own blood pressure and keep a record of her readings at home. One does not have to be a physician, nurse or tech to measure a blood pressure and once she learns the proper technique she is likely to get more accurate readings in her familiar and comfortable home setting. Tracking these readings will be much more valuable to Carol as she and her doctor determine the best course of action to take related to her blood pressure in the future.
Carol needs to purchase an automatic, cuff-style, upper arm monitor found at any pharmacy or medical supply company. It is VERY important to get the correct cuff size for her arm as improperly fitted ones can give inaccurate readings.
At home she needs a staging area with a high back chair (not a sofa) and small table next to it. She will place the machine on this table along with pen and paper calendar to keep a record of her readings.
Before sitting down to take her blood pressure she needs to remember to avoid exercising, smoking and drinking anything with caffeine for 30 minutes prior to taking the reading.
When ready, she will first go to the bathroom to empty her bladder. Then Carol will put the cuff snugly on her BARE arm (not over clothing) and sit straight with her back completely supported by the chair and both feet flat on the ground.
She will sit in this position breathing normally and consciously relaxing for about five minutes. She should not talk to anyone during this time of relaxation.
To begin the reading Carol will sit in the same above position and place her arm extended straight at heart level with palm up resting on the table. She will then press the button with her other hand and begin the reading. Carol will continue to breathe normally and attempt to keep her body relaxed including her arm as the cuff is inflated. The cuff is supposed to gently hug her arm, but for some people the hug can be uncomfortable. Again, she will need to focus on her breathing and relaxation.
Once the air is let out of the cuff and the reading is complete, then Carol will write the time she took the blood pressure, and in which arm it was taken, along with the reading.
At Carol’s next appointment with her doctor, she will take this calendar with her. She now will have accurate and concrete numbers to show which may or may not indicate White Coat Syndrome. Her record keeping will give her and her doctor a better understanding of what is happening to her and this will allow them to have a meaningful discussion on the appropriate course of action for Carol.
In today’s busy world, each of us must take an active role in our health care just as Carol did!