Why ‘White Coat Syndrome’ and The Pandemic Are A Double Threat

Seeking out medical help is hard enough for many, without the added risk of COVID-19 exposure

This year has been fraught with enough challenges to make anyone’s blood pressure spike. From wildfires around the world to the novel coronavirus pandemic, these past nine months have provided plenty of coverage to raise alarm. But for those with white coat syndrome, these circumstances have created additional cause for concern.

White coat syndrome, or ‘white coat hypertension’, is a phenomenon whereby patients experience elevated blood pressure when they are in the presence of a medical professional or when their blood pressure is being measured at a medical office.

When not in the presence of a medical professional or ‘white coat’, these same patients exhibit normative blood pressure levels. The presence of the ‘white coat’ triggers the physiological response of a subsequent rise in blood pressure. Essentially, it is a conditioned response by the body to react in response to the stimulus of the white coat. It is not unlike the renowned Pavlov’s Dog findings — except, instead of salivating when you hear a bell, your blood pressure rises when you’re in a medical setting.

If we consider that one of the criteria for white coat hypertension dictates that a patient’s blood pressure is otherwise normal outside of the medical environment, some may assume it is a minor problem. But research suggests this is not the case.

Patients with white coat hypertension are at a greater risk for heart disease when compared to others with normative blood pressure. For those that are aware of their white coat hypertension, and/or experience anxiety in response to a medical setting, it is not unusual for patients to avoid the medical environment altogether.

Conscious awareness isn’t always needed, of course. It is often the human tendency to simply avoid what we don’t like. This can spell trouble in a myriad of different ways, from a decrease in regular checkups to missed medical tests.

Double trouble — viral exposure concerns & hypertension

The challenges of white coat syndrome coupled with those of the novel coronavirus create a double threat. At the beginning of the pandemic, the National Syndromic Surveillance Program (NSSP) discovered a 42% decline in Emergency Department visits. A similar decline was seen in ER visits for heart attack, stroke, and uncontrolled high blood pressure. Some medical professionals have reported patients declining organ transplants due to fears of exposure to COVID-19 or because they cannot have a family member with them in the hospital. For persons with white coat hypertension, these effects may be amplified.

Unfortunately, heart attacks don’t stop just because we are in the middle of a global pandemic.

It is still important to get regular checkups and undergo any procedures which are essential to maintaining health. As we continue to navigate these uncertain waters, it is important that we do not allow fear to prevent us from taking care of our health.

Staying healthy during a pandemic means being your own advocate. Listen to your doctor and do your own research. Explore options for telemedicine, which can make healthcare more accessible whilst mitigating risks of in-person visits. One of the most important things you can do is to be mindful of your own health. In these uncertain times, being your own advocate is one of the few things you can control.


Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Dr. James Goydos
Dr. James Goydoshttps://jamesgoydos.com
James Goydos, M.D., F.A.C.S – Physician and surgeon specializing in Surgical Oncology. Experienced Professor of Surgery with a demonstrated history of working in the hospital & healthcare industry. Research has translated into clinical trials for patients with melanoma. Recognized for leadership in patient care by the Melanoma Research Foundation and The Cancer Institute of New Jersey (CINJ). Currently serve on the editorial board of the journal Clinical Cancer Research. Doctor of Medicine from Rutgers, Robert Wood Johnson Medical School.
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