Blood Pressure Examination Anxiety

QUESTION: I have had a terrible time trying to get life insurance because of
the blood pressure examination. Every time someone comes near me with that
thing, I tense up and know my pressure is going to read high. A friend told
me doctors have a name for this, and that understanding it could help. Will
you please enlighten me?
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ANSWER: Your friend is right in one context, but probably wrong in another.
Yes, there is a condition, called "White-coat" hypertension, that yields
higher readings of blood pressure in a doctor's office than occur in real
life, but no, knowing about it may not benefit you at all. Most investigators
believe this to be a chronic situation, and one that can not be resolved by
just telling the patients what they already suspect. It is most probable that
as many as 25% of the patients with high blood pressure readings taken as part
of a normal office visit actually have lower or normal levels when they are
tested by ambulatory monitoring methods which track a patient's pressure
throughout the day. Although monitoring can provide true readings, the cost
of renting the equipment and interpreting the result is high, as much as
$250-300 dollars, a cost high enough to drive your blood pressure up even if
it was normal. You can learn to take your own pressure, though, and if you
become skillful, your own readings may be more valid than those at the
doctor's office, and permit you to obtain a true reading, which in turn may
provide you with the evidence you need to obtain regular risk life insurance.
If this doesn't work, but you are still convinced you do not suffer from
hypertension, consult your own physician about ambulatory blood pressure
monitoring. He may be able to convince your health insurer of its necessity
in your case, and thus obtain insurance payments for you.