symptoms, causes and what to do about it

It is common to go to the nearest mental health center for a routine examination. There, 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 fall ill, very nervous. They have so many nerves that their blood pressure momentarily rises to such an extent that the values ​​are those of hypertension.

This phenomenon is known as white coat syndrome. and it is very important to keep this in mind when diagnosing and treating patients, because it poses a risk of treating hypertension that is not really real.

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 health care setting, such as a hospital, clinic or outpatient facility, with professionals “in white coats”. This condition is thought to affect around 30% of the general population.

In given spaces, it is common to measure basic vital signs, precisely to be able to detect if there are any health problems, such as temperature, pulse, frequency and blood pressure.

At first glance, white dress syndrome may seem unimportant, and even with a little humor. It depicts the classic situation of a patient, male or female, who is so nervous about being in the hospital that his nerves cause his blood pressure to shoot up into the clouds. However, what’s not funny is the risk of being treated as hypertension, which in reality is only a one-time case.

If the doctor or nurse does not consider the possibility that the patient has white coat syndrome, a false positive for hypertension may occur. It is true that normally this patient may have high blood pressure and will need to take medication, but what if not? What if your levels are normal when you are not in the hospital? In this case there is a risk of treating a healthy patient or giving them a higher dose of medicine than necessary.

It is common for people with white coat syndrome to be normotensive, which means that their usual blood pressure is not high and therefore does not require treatment for hypertension, because they simply do not have this problem. .


The explanation behind the occurrence of this curious phenomenon is that there are people who feel very uncomfortable when they are in healthcare institutions.

They interpret the place as a threatening environment, even though they rationally know they are safe and have nothing to worry about. However, his brain does not see it that way and sends an alarm signal to the whole organism. This causes an increase in several vital signs, including those that doctors and nurses measure, such as blood pressure.

In some patients, having a doctor take their vital signs causes them to increase on their own. Of course, this a lot depends on the negative predisposition of the patientif he is more or less nervous than usual, or if he perceives the hospital as a place where you get bad news and is worried about what his doctor may tell him.

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

  • Anxiety
  • Depression

  • fear or dread
  • Fear of death or thanatophobia
  • Hypochondria
  • Reaction to specialist expertise (doctor or nurse)
  • Stress
  • Negative environment
  • Improperly calibrated blood pressure measuring instruments


White coat syndrome is diagnosed when a doctor or healthcare professional notices that the patient’s blood pressure values ​​taken at the health center do not correspond to the usual values. That is, if the doctor finds that the patient’s blood pressure is generally lower when not in the hospital, consider the possibility that the patient was very nervous when this constant was taken, at such point that it was identified. like hypertension.

Given 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 for the patient to measure his blood pressure at home, following the advice of experts.. If you do it at home, quietly, quietly and at a pleasant temperature, you are more likely to obtain blood pressure values ​​that are more in line with reality, whether healthy or indicative of high blood pressure.

If the home levels are within those considered normal but those taken in the hospital are significantly higher, it is highly likely that the patient has white coat syndrome or that the day they went to the hospital he got nervous about being there. He is a normal person, even if the devices used by the doctor say otherwise.

What to do and how to properly measure stress?

Finally, we don’t want to end the article without clarifying some of the general recommendations for the correct measurement of blood pressure, whether at home or in a hospital setting. There are some aspects that may seem trivial, but this is precisely what makes the difference between a false diagnosis of hypertension and a real one, caused by real blood pressure problems.

There are details that can raise blood pressure values, the most obvious being take the measurement in times 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, etc.). No sporting activity should be practiced the hour before taking your blood pressure and it is very important to urinate before the test, as wanting to urinate can alter the results.

These recommendations are useful both when the measurement is carried out at home and in a health centre. Considering that pharmacies are health spaces where the time that the patient can stay there is not so limited, unlike hospitals, it is recommended to do so in the usual pharmacy, trying to be relaxed and being able to repeat whenever you want.

If blood pressure levels are normal at home later, no treatment is needed, although it is advisable to maintain a healthy lifestyle. Care should be taken to eat a healthy and balanced diet, not to eat too much salt and to exercise regularly.

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