This term refers to the rise in blood pressure you might experience around healthcare professionals — people in “white coats.”

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If you feel nervous or very anxious around healthcare professionals, the term “white coat syndrome” might apply to you.

While not an official diagnosis, it’s a term often used to describe the rise in blood pressure that some people get in uncomfortable settings, like at a doctor’s office.

In addition to generally feeling anxious around doctors, you might also experience white coat syndrome if you’re worried about receiving negative or life threatening news.

White coat syndrome causes the blood pressure readings your doctor or nurse takes to be less accurate than the results you might get at home or in a less stressful setting.

About 15–30% of people who have elevated blood pressure in a doctor’s office setting have white coat syndrome.

In general, risk factors for hypertension — or a blood pressure reading that’s above 120/80 mm Hg — include:

  • age
  • obesity
  • tobacco use
  • little physical activity
  • stress
  • heavy alcohol use
  • a diet low in nutrients

But white coat syndrome isn’t a regular case of hypertension. Many people who experience white coat syndrome show typical blood pressure levels when going about their day-to-day lives.

Still, white coat hypertension may raise a person’s chances of cardiovascular disease.

Knowing how to tell if you have white coat syndrome and how to handle it can help make your trips to the doctor less stressful (and those annual physical exams much easier).

The signs that you’re experiencing white coat syndrome are pretty straightforward.

Simply put: If you’re experiencing anxiety in medical settings and getting higher-than-usual blood pressure readings, chances are white coat syndrome is the reason.

But how do you know your blood pressure readings are really higher in a medical setting if that’s the only place you’ve been able to get it taken?

To be sure your blood pressure is really higher in a doctor’s office or clinic, you may need to ask your doctor if it’s possible to monitor your ambulatory blood pressure (your regular blood pressure as you go about your daily routine).

You can also check your blood pressure at home later if persistent high blood pressure isn’t an immediate concern for you.

There are a few specific causes of hypertension at the doctor’s office.


Anxiety is the primary reason your blood pressure may be higher at a doctor’s office, hospital, or clinic than it would be if measured at some point during your daily routine.

How does anxiety increase blood pressure? It causes the release of stress hormones like adrenaline and cortisol into your body. These hormones then cause your heart rate to increase and blood vessels to narrow.

These things can cause blood pressure to rise.

So if you experience high levels of anxiety or an anxiety disorder, being at the doctor’s might spark your anxiety. For example, if you live with generalized anxiety disorder, sitting in a doctor’s office might cause you to feel worry and stress to the point that it increases your blood pressure.


Trauma is a natural, emotional response to events like natural disasters, accidents, or assault.

After a traumatic event, you may experience shock or denial. Longer-term reactions can also include:

  • intense emotions
  • flashbacks
  • strained relationships
  • physical symptoms like headaches or nausea

These symptoms can be a normal part of your trauma response and become even more noticeable in high-stress situations — like being at the doctor’s office.

Some research has found that people with PTSD may have a higher likelihood of experiencing hypertension and stroke.

Past medical distress or trauma

If you’ve had a traumatic experience at a doctor’s office, you might be more likely to experience white coat syndrome.

A traumatic experience with a doctor can include:

  • a procedure that causes pain, especially unexpected
  • learning you have a life threatening medical condition
  • experiencing sudden medical issues, like a heart attack
  • witnessing a family member pass away in a hospital

Doctor’s offices and hospitals can be tension-filled environments. And if you’ve experienced trauma or distress in a medical environment in the past, these places may be more likely to set off your fight, flight, or freeze response — meaning your blood pressure may rise.

If you have anxiety only in this specific setting, your white coat syndrome probably won’t cause any long-term harm.

As long as your anxiety isn’t persistent, your health likely won’t be affected in the long term.

But if you regularly experience high levels of anxiety (in or out of medical settings), this can result in a variety of health issues if left untreated.

Persistent anxiety can affect your heart and blood vessels in the same way that long-term high blood pressure can.

The caveat here is there’s a good amount of overlap between people with anxiety disorders and those who have white coat syndrome. Research suggests there’s an association between long-term cardiovascular issues and white coat syndrome.

If you think you’re having white coat syndrome, know that it is possible to become more relaxed and even lower your blood pressure readings in medical settings.

First, you can start by letting your doctor or nurse know before they start your physical exam if you’re feeling physically anxious. You might say: “I’m feeling some anxiety right now, so my heart rate and blood pressure might be higher than usual. I’d like a quick moment to calm down a bit before we start.”

While opening this dialogue with your doctor might feel scary, it can give you the time you need to calm your nerves and let them know what’s up.

But what do you do with your moment of calm? You could do a 1-minute mindfulness exercise or practice some deep breathing.

You could also potentially take your blood pressure reading at home if you think your readings in-office aren’t accurate. And you can always check in with your doctor if getting your ambulatory blood pressure taken is a better option for you.

If you think you might have white coat syndrome, it can help to communicate this to your doctor. And in the meantime? You may find treatment options for anxiety useful in managing or preventing temporary spikes in your blood pressure that’s caused by anxiety.

White coat syndrome vs. masked hypertension

Masked hypertension is having high blood pressure that doesn’t show up during your physical. In other words, it’s the opposite of white coat syndrome — with masked hypertension, you may have higher blood pressure outside of a medical setting, but it will show up in the “normal range” when at your doctor’s office.

Because higher blood pressure can result in a higher chance of heart attack and stroke, if you think your temporary hypertension might be impacting your health, it’s a good idea to chat with your doctor about treatment options.

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