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Blood Pressure Too High In Doctor's Office

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Q. I hate having my blood pressure taken at the doctor's office. The numbers are always a lot higher than the measurements I get at home.

For example, last week the nurse got a reading of 170/86, but when the doctor came and took it again with the same instrument, the blood pressure was 154/82 in my right arm and 130/80 in my left arm. At home the measurement usually ranges from 125 to 140 over about 80.

I take amlodipine, lisinopril and hydrochlorothiazide. They make me feel dizzy and tired. Are there any natural remedies for lowering blood pressure?

A. We're not surprised that your doctor would want to treat your high blood pressure. A brand new study suggests that even "prehypertension: may increase the risk for strokes. Researchers reported in the journal Neurology (online, Sept 28, 2011) that people with systolic blood pressure between 120 and 139 and diastolic blood pressure between 80 and 89 have a 55% higher risk of having a stroke compared to those with lower blood pressure readings.

That said, you may be suffering "white coat hypertension." Many people react to having blood pressure taken in the doctor's office. Measurements may be 20 points or more higher than the normal reading. Home blood pressure measurements can be helpful for such individuals.

There are many approaches to blood pressure control. Exercise, weight loss, relaxation and minerals such as magnesium can be useful.

Don't stop your pills but let your doctor know you are not feeling well. The right medications in the right dose should control blood pressure with minimal side effects.

Anyone who would like to learn more about non-drug approaches to controlling hypertension should find our Guide to Blood Pressure Treatment helpful. It discusses proper techniques for blood pressure measurement and discusses the pros and cons of many medications.

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24 Comments

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I've always been weird. For 79 years my BP was 118/70. Last March I developed severe headaches and my BP was 175/130. For six months I've reduced salt -slightly-, been unable to increase exercise, and BP now can range from 195/130 to 110/64 within 30 minutes. So I do not have hypertension, I have a weird BP and the doctors don't know what to do about it. As long as I don't have headaches it doesn't bother me.

Most recently I did find a study in JAMA, I can't remember the date. Patient blood measurement are correct. The White coat hypertension are not correct. Please check into it.

Mat

When I was first diagnosed with high blood pressure it took almost 18 months, several different combinations of high blood pressure medications, before the right combination was found that would not make me feel tired or dizzy and keep my blood pressure stabilized. I've discussed this subject with family and friends and find that finding the right combination of medications is normal.

I think if you try to eat more vegetables specially greens and as much as you can raw veg. and omit red meat, together with exercise like walking will help you. Also some foods, spices and herbs help, check previous comments advice here. Quest.-answ.

Mine is the opposite. I---and others---take my BP away from the clinic, and when I get to the clinic it is almost normal. It is scary.

I love your website and all the information I obtain here. As a Master's prepared registered nurse with 35+ years of experience, I know that there are many more situations than the "white coat syndrome" which can result in an elevation in blood pressure - stress in general, at work, at home, in traffic, in a personal tragedy or worrisome situation, etc. Various medical diagnoses, including pheocytochroma. I believe the correct thing to do is to educate about these types of situations, in addition to the doctor's office experience.

People with blood pressure concerns need to be aware, and to monitor their readings in various types of situations. Obviously there are drugs which dampen blood pressure reactions in general, primarily by inhibiting heart rate, and those who do tend to react with higher readings during periods of stress should be considered for these.

I have the same problem. As soon as I walk in the door or shortly after the nurse takes the blood pressure and it is always higher. The doctor rechecks it when he checks me and it is lower. The time in between lets me relax a bit.

What raises my blood pressure is waiting an hour past the appointment time

Every time I have my BP taken, they have to use a over-sized cuff because of the size of my arm. The nurse pumps the sleeve up until there is excruciating pain in my arm before they release pressure. This is done twice now these days for "accuracy". Having pain causes a higher BP reading and when I take it at home (wrist monitor ((tested for accuracy)), my BP ranges from 119/64 or 120/70. I refuse to take BP medications when the cause of my high BP in the doctor's office (not white coat, but pain), has nothing to do with me physically.

Thanks for the info on high blood in dr. office mine goes up to. I will tried magnesium.

Have had a similar experience. I get my blood pressure checked by my primary doc & it's a good reading-when I had surgery a couple years ago they are getting such low readings that they wouldn't give me the meds for blood pressure, yet, I go to the cancer doc & he always has a fit that my pressure is too high!!???

Never mind that he will do it a couple times & the cuff is tight & hurts on my arm--doesn't that raise blood pressure. I must admit I do feel a bit concerned when I go for my yearly check-ups--what may they find now? Doesn't that help make a difference as well?

Sometimes I get the "white coat syndrome" and sometimes I don't. I always tell the nurse what is going to happen. Just getting into the building is an effort for me and raises my pressure. When the doctor comes in and checks it, it may be 30 to 50 points lower. I am on blood pressure medication. My readings at home are always MUCH lower.

I have read and seen several reports recently in the last several months about using the correct technique to take accurate blood pressure readings. I do not remember if this has been in the Peoples Pharmacy or not, but if not it needs comment that many of the ''trained'' medical persons who administer the test do it wrong. Things to consider are correct placement of the band and correct size of the band, position of the arm, and more. Please Peoples Pharmacy do a article or repeat a previous article again on this.

By the way, how often should a home blood pressure monitor be checked for accuracy and what are the best ways to do so?

Hello,
Here is the way I was able to lower my BP at the Dr. office: Arrive at least 15 minutes early and find a chair that you can lean your head back and rest. Don't talk to other people if you can help it. Tune everyone else out especially the Tv that is probably there.

Take some deep breaths, close your eyes and visualize your self lying on a beach while letting the cool breeze blow over you. Continue to take some deep breaths.
This exercise is important especially if you had to drive in heavy traffic for a half hour to get to the Dr. office.

This works for me every time. Doing this, my BP has been as low at 110/60 when usually it is 130/70.
Regards

My blood pressure is ALWAYS higher at the doctors office. I monitor my blood pressure at home and it is generally perfectly fine. Last reading was 120/74. Home monitoring devices are as good as the ones in the office, perhaps even better because they aren't getting all the wear and tear. Just tell your doctor that you prefer to monitor your blood pressure at home.

I have border line high blood pressure . Yet when it was taken last it was 180 / 93. Whenever it is taken I have the excruciating pain in my arm. I thought I was the only one till I read someone else had the same feeling. My arms are larger than most, not fat. I have told the doctor, thinking maybe it was normal.

Every time I try taking blood pressure medicine I get very dizzy and have a hard time walking. I get very tired to the point I need to sit, even lie down.
Not sure what to due?
RLM

RLM, ask your Dr's office to use the larger blood pressure cuff. Yes, they do make larger cuffs for bigger people! You think the body builders of this world could get their arms in the regular cuffs?

My father wasn't feeling good today and went to the doctor. He felt dizzy and his head was pounding. At the doctors office, they took his blood pressure. His BP was 150/90. They let him WALK OUT and told him it was normal. I am concerned about his health. I thought clinics weren't supposed to let you walk out of the clinic until your BP was NORMAL?

That is on the high side Lily, but not terrible. A lot of people have what is called "white coat hypertension." What happens is when they go to a doctors office their blood pressure goes up. It is a well known phenomena among medical professionals who deal with patients and it is actually fairly common. Were they to have kept him at the office I bet his blood pressure would have inched up, not down from being anxious. Have your father monitor his BP at home with a good device. That will give a better picture of what his BP really is.

Last time i measured my bp @home using Omron bp device it was 146/88 I went to the pharmacist shop and it was 170/80 using a manual device why is it different? I am 31yrs and 90-100kg right now am on 10-20kg lisinopril 50-100mg atenolo and 1 normoretic a day so why is the reading different...

I have been diagnosed with mild kidney disease with 70% renal function. I have 2nd stage hypertension as a result and my cardiologist and nephrologist have not been able to discern if the high BP caused the kidney damage or if the kidney disease is what is affecting the kidney. Storyline is that I ave been on anti hypertensive drugs since 2009 and the shocking thing is I'm not even 30yet. My bp has gotten as high as 180/120 on several occasion and we ave tried so many combos but bp is never low but always so high despite all the atenolol, lisinopril, diovan, aspirin, prasozin, amlodipin, and diuretics, it doesn't come down. When I check my bp and I see it as high as 170/130 and I ave not had a heart attack, I am always amazed.

It is especially high when I'm at the hospital but when I use my bp monitor at home, it still gets as high as 150/110 sef. I don tire. And my specialists are even saying I should hold on and not get pregnant as my bp needs stability. What drugs can I take to slow down the kidney issues while reducing the bp drastically? I'm really at my wits end here.

At home, with a known validated and accurate device, my BP generally runs 135-139/65-72. Just last week at the Doctor's office it was 180/100.

I have no problem going to the doctor's office, but they are seriously bad at following their own advice. BP should be taken after resting for approximately 15 minutes (5-10 works for me) and not immediately after you make the long walk from the parking garage. Or after the long walk from the waiting room and having to sit on a back-breaking exam table instead of a chair.

My home BP device has print capability so I've gotten into the habit of taking ten or so readings and printing them out. And since my Doctor has confirmed the accuracy of my device, I feel really good giving them my results obtained at home.

For me "White Coat Syndrome" is very real but I just decided I would no longer accept what I knew was an anomaly. My Doctor approved and was actually quite pleased I took such pains to monitor myself and keep good records.

I have white coat anxiety, and yes it is real, too real for me, I cannot see the doctor without clenching up. At home my Blood pressure readings are 115/73 to 130/80, but in the doctors office 140/90, in which my heart races, I also cannot do a urinalysis on demand, I am so terrified of Doctors... unfortunately I recently became a type 1 diabetic, so doctor visits are now a regular part of life for me for 3 years now, I am very strict, and watch every carb I eat and have good blood results 6.5 A1c last check up, but am still being scrutinized, and told I need to be seen in only two months because I had 1 low blood sugar of 48 in two weeks. I Had been told if my A1c was good, I could go 3-4 months instead... I got a you can't do any better, good job! See you in 2 months! I said I thought you said if it was good I could get a break from visits he said you had 1 low blood sugar .... we'll see how it goes it goes in two months. This place had been trying to put me on Metformin but I didn't go for it as I am not a type 2 and I am very sensitive to insulin.

I am 24 years old and weight 58 kg. Three days before I had measured my blood pressure. It was 180/93. Please give me suggestion to reduce my bp to a normal level. Please. I am astonished such a level in an lower age.

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