@gwhap and @iamweasel2112
I have had this terrible affliction since maybe 8-10 yrs of age. And for me, there is no doubt about it. It is a terrible, terrible feeling that at worst, may start a week before an upcoming visit, if I let it. As is, at the very least, from the moment I park my truck, heart rate increases to well over 100. 160bpm in the ER one time, years ago. And my blood pressure goes upwards. Drastically upwards. That's the physical side of it. The mental part makes you want to leave. It is classic fight or flight response. Many of us forgo needed medical attention because of this weird blood pressure thing. Going many years at a stretch with zero health care encounters is not at all uncommon among us. I went almost a decade one time years back. Had self purchased insurance the entire time. Was just in case I needed it. Turns out, I didn't. Ha.
To answer you both, I have read countless studies on this affliction. Countless. As gwhap mentioned, there are those that do not even know they have it. I tend to rank that as more effect than syndrome. I think most everyone has a slight rise in BP in a clinical setting. Maybe imperceptible so far as self reported anxiety. And those folks are where the 20% to one of the first studies done on this showed 30% of cohort showed a WC Effect. May have been you, iamweasel . Your blood pressure goes up a bit walking in, but so far as any real anxiety, not enough for you to notice. Now, it has been suggested and gwhap mentioned this as well. Does the WC Hypertensive have these spikes in everyday living? So. For me. I don't ever get that nervous, mad, scared, what so ever, day to day, as what a clinic visit does. The only other times I can think of that I feel the same way in clinic is minutes before I am scheduled to speak in front of a large audience. Say….Singing the National Anthem at The Super Bowl. Live. I'm not kidding. They have even done studies to test that very theory. The results of us WCH were nearly identical to putting us on a stage in front of our entire home town. For the WCH, I want to say our response to such was slightly more pronounced than the normo, or hypertensive subjects. So, for me? Not even close.
One more thing I'll mention. A study early on…Was just the 80's that Thomas Pickering, M.D. actually coined the term “White Coat Hypertension”, though Rivva Rocci first mentioned some subjects become excited when measuring their blood pressure, way back in the early 1900's. He suggested handing them some sheet music or some such to take their mind off of the task at hand. Hmmm….I doubt that worked then, and it sure wouldn't work for me, now. If only it were that simple. An early study suggested that WCH could be no more than 20mmHg Systolic and 10mmHg Diastolic, rise in BP from a 24H awake daily average BP to a cuff measured BP taken manually, in clinic. Shoot. My systolic can easily climb 40 points from normal. I think those numbers are not used for basis anymore. I just got a kick out of it thinking that lady certainly doesn't suffer this affliction. Anyone that does, knows those numbers are a walk in the park to beat.
Thanks for responding. It's a fascinating subject to me, despite the craziness of it.