Blood Pressure False reading

[rov1200]

Whats the remedy for a high BP reading because of 'white coat syndrome'? Hospital requires a normal reading before willing to operate. When taken at home the reading is near to normal.

[theprof]

I'm assuming that you have an electronic blood-pressure meter that you bought yourself over the internet or via a pharmacy etc. Some of the readings from these devices are regarded as inaccurate by some doctors/surgeons for various reasons and consequently, you may never be able to persuade the doctor/surgeon that your blood pressure is OK even after taking "white coat syndrome" into account.

The best answer for you is to try to persuade your consultant to have you fitted with an ambulatory blood pressure monitor, which is device that records your blood pressure over 24 hour periods. When you return to the hospital, the recording will be examined by a technician, who should be able to confirm to your consultant that your BP remained within more or less normal parameters for the period under study. This should leave them with little doubt that you do indeed have "white coat syndrome"

Finally, it's important that you don't over exert yourself during the 24 hours or so the device is fitted to you, so digging the garden, vigorous activities in the bedroom etc are out. In any case, you'll probably be advised to keep a record of what you were doing hourly in case there are any peaks in the recording.

[alexanderd]

my partner had the same problem and was advised to buy her own monitor and use it twice a day for two weeks then go back with the record. Any abnormalities should be recorded with what you were doing at the time

[grasscarp]

I was once told by my doctor that my blood pressure was too high and he was leading the conversation towards some kind of treatment. I told him that I didnt agree with him, so was give the 24 hour equipment that the prof has mentioned. This showed that my blood pressure was normal (I am pleased to say).

[rov1200]

Thanks for the replies.

We do possess one of those monitors and have used it today. Both readings are below the hospital ones.

At 8am it read 190/109 which I know is very high

but 4 hours later it read 172/99. I don't know what to make of it?

[Sqad]

Excellent reply by the prof.

A few added points....I am not sure that the NHS could afford ambulatory pressure monitors to all patients being investigate for hypertension.

How accurate do you want these B.P monitors? Surely within 5% accuracy and taken 3 times a day for a week should give the Dr. some idea of the readings.

"White collar Syndrome" does exist, but in my opinion is a card that is "overplayed"

rov1200...we have been over this in past threads from you....you have established hypertension and you need treatment....why not face up to it?

[rov1200]

Squad who said it was for me? Are you married? When you have a partner you also have to consider someone else and a second opinion usually helps.

[Sqad]

rov, whether or not it is for you or anyone.............mu comments remain unamended.

[Sqad]

and yes I am married.

[Spadina]

You must take your blood pressure using a home device (US$ 50) once per day at the same time, right after getting up in the morning, before eating or showering. Do this once a day for 2 weeks and show the readings to your physician.

[bednobs]

how old are you? a reading of 172/99 is high by anyone's standards, not really "near to normal" - i hate t imagine what it is when taken in hospital if it is lower at home
It might be better to investigate having treatment for high blood pressure in order to have the operation. I wonder why the consultants aren't consulting with the GP to get treatment started?

[theprof]

I agree with Sqad that the cost of ambulatory blood-pressure monitors is prohibitive, although requesting one might be acceptable if your local hospital is a large one and/or you happen to inquire at a time when the devices are not being used by other patients. Yes, in an ideal world, the hospital should have written to your GP recommending hypertension therapy, but in reality, that letter may have not gone out yet or it may have been filed away or put on the practice database for the GP to see the next time he sees you.

White Collar syndrome is undoubtedly overplayed to my mind as well. I think the best thing you can do is to ring your GP Surgery and ask if they've received a report from the hospital regarding your hypertension and the postponement of your operation. When they say they have, make an appointment with your GP and discuss the matter with him or her. The GP will undoubtedly take your blood pressure again and if the hypertension is confirmed, they'll begin the appropriate therapy.

If the surgery hasn't received a report, get in touch with the hospital again and ask them to write to your GP about your hypertension and operation. Explain that you're in limbo until the GP receives the report. The consultant's secretary would be the ideal person to speak to about this.

A lot will depend on the urgency of the operation, but by working with your GP, the hypertension should come under control fairly quickly enabling your suitability for the operation to be re-assessed by the hospital.

[theprof]

bednobs, age is a factor to be taken into account with all blood pressure readings. 172/99 is not particularly high for an adult in their seventies or older. It would be unusual for someone in their thirties or forties.

Consultants don't consult with GP's : the converse is the norm. The GP is expected to wait patiently until the consultant provides his or her theoretically more learned opinion on the case and it goes from there. Ultimately, it's the patient that's kept waiting which is why I made those suggestions to rov1200 in my last post.

[BertiWooster]

I'm suprised that your high BP was not picked up by the hospital some time before - have you been seeing them for some time before, with regard to the operation ?

Some while ago i had to have an operation - however my hypertension was discovered by the hospital in good time before the operation and therefore was able to be traeted by my GP without delaying my operation .

If the operation is non urgent you could opt for further investigations , however if it is more urgent or there is a long waiting list for theatre time , personally i would go down the route of medication

If you really think that you are suffering from ' white coat syndrome' - why dont you go for checks at a NHS walk in centre , which is a more relaxed atmosphere ( assuming there is one near you )