For most people, going to the doctor is usually a bit nerve-racking. But for some, the stress of a medical appointment causes a temporary rise in blood pressure. If that is the case for you – and if your blood pressure is normal at home and in other non-medical institutions – you may have so-called white fur hypertension. Now, a large study suggests that people with this condition have a greater risk of heart disease than people whose blood pressure readings are always normal.
According to current guidelines from the American College of Cardiology and the American Heart Association, normal blood pressure is defined as less than 120/80. High blood pressure is 130/80 and higher.
“If your blood pressure rises under the relatively non-threatening situation of visiting a doctor, what can happen if you are cut off on the highway, or experience a challenging family or working conditions?” Randall Zusman, cardiologist at Massachusetts General Hospital, affiliated with Harvard.
Everyone’s blood pressure fluctuates constantly throughout the day. But people with white coat hypertension can experience higher and higher peaks more often. About one in five people has the condition, which doctors usually do not treat with medication.
The effect of the white fur
For the study, researchers bundled findings from 27 studies with more than 64,000 people in the United States, Europe and Asia. Compared to people whose blood pressure was normal in the office and at home, people with untreated white coat hypertension had a 36% higher risk of heart attack, stroke and other heart-related events. They were also twice as likely to die from heart disease.
People taking blood pressure medication whose blood pressure was still rising at the doctor’s office (a phenomenon known as the effect of the white fur) did not have a higher risk of heart disease. The study was published in Annals of Internal Medicine on 10 June.
According to Dr. Zusman’s findings provide further support for the treatment of people with white fur hypertension. Research suggests that the condition almost always progresses to persistent high blood pressure.
What you can do
However, treatment does not necessarily mean blood pressure medication. “Losing weight, exercising, limiting salt and not smoking are all associated with better blood pressure control. I certainly encourage people to do all of those things, whether they have intermittent or prolonged high blood pressure, “says Dr. Sister.
Sometimes even determined efforts to make these changes are not enough. If lifestyle changes aimed at controlling hypertension cannot bring your blood pressure within a normal range, there are many safe, effective drugs that can help.
Dr. Zusman advises all his patients to use a blood pressure monitor at home to check if their treatment works. “I also let them take their device and see how they record their blood pressure to make sure they use the monitor correctly,” he says. Doctors often suggest checking your blood pressure once or twice a day for a week or so immediately after starting or changing any medication. After that, two to three times a week at different times is a good idea, says Dr. Sister.