White Coat Syndrome: Empowering Patients

Written by Elizabeth Montoya and Edited by Josephine Chan

White Coat Syndrome, also known as White Coat Hypertension (WHT), refers to hypertension (high blood pressure) that occurs in certain individuals when visiting doctors’ offices [1]. Though seemingly innocent, it can hint at more serious blood pressure conditions like hypertension. The question is not how to manage this condition, but how to improve quality of life for those affected by it and how to minimize their health concerns. If there exists a fear of going to the doctor’s office, there is also a lack of trust between these patients and their healthcare providers.

This syndrome was discovered in 1896 by physician Scipione Riva-Rocci when he noticed that some patients experienced an increased blood pressure when visiting his office. Extensive research began in 1983 to study the notion that patients experience increased blood pressure and heart rate when seeing the doctor, but white coat syndrome is something that is still being researched [2]. In recent studies, the syndrome appears to be a precursor to high blood pressure. WHT is also often misdiagnosed as hypertension, which can lead to strokes or heart attacks. Fortunately, White Coat Syndrome is relatively easy to treat.

However, a correct diagnosis is important to prevent unnecessary and potentially harmful medicine intake [3]. When those with WHT are not properly treated, they are put at risk for the development of other chronic illnesses, such as cardiovascular disease. For example, untreated individuals with WHT are 36% more likely to experience a heart attack or stroke and are twice as likely to die from a heart disease if left untreated [4].

What healthcare providers can do to prevent this development is to ask the patient to record his or her blood pressure outside of a medical setting. With patients being in charge of their own health, data is provided in real time for their doctors to determine if they are affected by WHT and provide treatment. Once patients receive the proper medication, the possibility of contracting heart diseases decreases and heart rates stabilize. Nowadays, it has become increasingly common for healthcare practices to ask patients to take out-of-office blood pressure measurements [5]. Having the patient’s records of blood pressure can help distinguish between white coat syndrome and regular high blood pressure [6]. It is important for this distinction to be made accurately, as an individual with WHT cannot take medication intended for patients with high blood pressure because it could lead to hypotension, also known as low blood pressure.

As a patient, there are ways to alleviate white coat syndrome, all of which can benefit one’s overall healthcare experience and ensure proper diagnosis for any ailment. A method of improving the outcomes of WHT is to improve patient-to-health provider communication by establishing empathy and trust [1]. The starting point is identifying the source of the patient’s anxiety, confronting it, and going over available treatments. If possible, having an individual accompany the patient during a visit to a healthcare professional can help ease stress and create a support system, as well as implement the idea that the patient and doctor are a team when it comes to quality of life and health [7].

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