Do you suffer from white coat syndrome?

Does your blood pressure soar sky high every time you visit your GP but seems to register as normal if you check it at home? If so, you could be suffering ‘white coat syndrome’, which is thought to account for around 25 to 30 per cent of attendances at high blood pressure clinics.

The syndrome is thought to occur due to a combination of the anxiety people feel about seeing a doctor and the fear that something might be wrong with them.

“These feelings and emotions set off the body’s fight, fright and flight stress response, causing the release of adrenalin,” explains Dr Deborah Lee from the Dr Fox Online Pharmacy.

“As a result your heart beats faster, your breathing rate increases, the stress hormone cortisol is released and there’s a rise in blood pressure.”

So, how can you calm those nerves and make sure your doctor gets an accurate reading when they give you a check-up?

Book a morning appointment

Dr Lee advises that you book an early morning appointment as the best time to take your blood pressure is about an hour after you wake.

“Arrive a little early for your appointment and take some time to relax in the waiting room,” she says.

“Sit properly in your chair with your arms relaxed by your sides and your feet on the floor.”

Also avoid caffeinated drinks and alcohol two hours before your appointment and don’t smoke or exercise strenuously in the 30 minutes before your visit.

Have a banana

Low blood sugar can elevate your blood pressure so it’s vital to have breakfast before your appointment and a banana is a great option. “As little as 15 minutes after eating, your blood pressure starts to fall,” says Dr Lee. “Bananas lower blood pressure because they are full of potassium, which is thought to improve the elasticity of the blood vessels.”

Know when to speak up

If your GP is aware that you are anxious they can take steps to put you at ease. But while it’s important to tell your doctor your fears, Dr Lee suggests staying silent while your blood pressure is being taken.

“Talking during the procedure can alter your blood pressure reading,” she says. “However, when you are addressing your concerns before the procedure it’s important to make sure the doctor uses the right cuff size as the wrong one can alter a blood pressure reading by as much as 50 mmhg (millimetres of mercury), which is a lot. It should wrap snugly around your arm, with a little space to slide two fingers underneath.”

Try deep breathing

Deep breathing has been shown to lower blood pressure. “The key is to use the diaphragm to breathe as this activates the nervous system which is the body’s mechanism of dampening down anxiety and feeling calmer and relaxed,” says Dr Lee.

“Try the 4, 7, 8 method where you sit quietly, breathe in through your nose, sucking in your abdomen and feeling your chest rise as you do so, for a count of four. Hold your breath and count to seven, then breathe out slowly to a count of eight, and repeat.”

Go to the loo

Believe it or not, going to the toilet before your appointment can improve your blood pressure reading.

“Needing the loo can increase your blood pressure by 10 mmhg,” says Dr Lee. “Studies have shown that blood pressure goes up with bladder distension so blood pressure should be measured after passing urine, and not when you are holding on to the urge to pee.

“Drinking water has the opposite effect though as it causes the blood vessels to constrict, making your blood pressure rise, so wait until after your appointment for a drink.”