Because my mom has high blood pressure, I check my blood pressure regularly at work (even though she is fat and I am slim – but ever since I had experience of it being high in a doctor’s office and almost-high when I was slightly overweight). It is usually around 119/79. If I get stressed out at work it sometimes jumps a few points up, maybe to 135/85, but comes down fast. Even if I check it right after going down stairs or walking around the building, or after sitting in traffic, it is still in the normal range.

But when I have to go to a doctor, it gradually starts going up for a couple of days before the visit. By the time I am in the office, it jumps all the way to 140/90, occasionally even higher. Sitting in a chair waiting doesn’t make a bit of a difference, it may even make it go higher. At the end of the visit it usually starts going down, so sitting on a chair after the visit might make a difference, but not before. Because you see, before the visit I keep thinking about the visit (and what my blood pressure would be) and the more I think about it, the higher it goes. I know it is irrational. After the visit it comes down very fast, by the time I am at work it is back to normal.

I don’t know how other people react. I would imagine that if I had stressful situation where I am worried for a few days, my blood pressure would go up as well. But not the way you describe, not in response to short-term stressful situations.

Does it in fact constitute a part of the spectrum of hypertensive disease? Some patients do not experience the whitecoat syndrome, and probably do not spike blood pressure in response to any of a number of other provacateurs in daily life. Those who increase blood pressure in the presence of a physician might also be more prone to hypertension in traffic, when hearing the latest news from the middle east, when dealing with an overbearing boss and other normal events of life. That is, whitecoat hypertension might be nothing more than hypertension that is medically dismissed and untreated because we think of it as spurrious rather than reflecting actual physiology.

I’ll bet there must be some continuous ambulatory blood pressure study that compares 24 hours average blood pressures with these above situations.