Ask Dr Gary: Monitors can have drawbacks

I am a healthy 36-year-old male. Recently I bought and began using a blood pressure monitor. I have had readings as low as 118/74 at home but at my GP they've been as high as 150-160/100. On the last couple of visits to my GP, I felt nervous, hot under the collar, and can almost hear my own heartbeat going 10 to the dozen. Obviously the reading is a lot higher than what I can get in the calm, relaxed environment of my own home. I understand it can be dangerous to self-diagnose, but what are your thoughts with the two results? Is this a case of what I have heard called white-coat hypertension?

Great question. And the short answer is: it sure sounds like it.

Next time you visit the doctor take your blood pressure unit and compare the readings to see if your machine is accurate.

Also, keep a log of your blood pressure in the morning, before activity, stress, and caffeine kick in, and share it with your GP. Discuss your concerns with your GP openly. They want the most accurate and reliable information, too.

In general, I don't think personal blood-pressure monitors are a good idea. They seem to generate anxiety in most people who own them (or perhaps it is the most anxious people who tend to buy them. However, they can help uncover white-coat hypertension, a rise in blood pressure caused by the anxiety of being in the doctor's office.

The essential thing to remember about "essential hypertension" is that it causes damage over long periods of time - not hours or days, but years. What your blood pressure reading is at this very moment is largely irrelevant. It's the average pressure day in and day out that matters. When you lift weights or strain, for example, it can skyrocket over 200.

Illness or anxiety can raise it as well, but that's not a problem, because it comes back down. Much worse are smaller elevations in blood pressure that persist for years, wearing out the pump (the heart) and the hoses (the vessels), and leading to higher rates of stroke, heart attack, and kidney disease. The goal is to get your average blood pressure to less than 140/90 and keep it there, reliably, over time.