We all know about the link between high blood pressure and strokes and/or heart attacks. In my slightly unscientific mind it is something like blowing up a balloon a little too much a few too many times.

There is a thing called white coat syndrome, named such because of the white coats that most doctors used to wear when they would see you in their office (they’re much more casual now). Anyway, the result of white coat syndrome is that a person whose blood pressure is normally, if not always, in the normal range, will without fail have a spike in their blood pressure readings when they have their blood pressure taken at the doctor’s office.

Studies have shown that white coat syndrome has little or nothing to do with a conscious fear of going to the doctor, the doctor or nurse themselves, or the office. It is apparently some kind of subconscious reaction. But, conscious or subconscious, the result is spikes in blood pressure that, if they were the norm, would have to be treated as they are generally spikes to very high levels.

The dance I wonder about in all of this is, if a patient is determined to have white coat syndrome and not treatable hypertension, what if there are other things that subconsciously elevated their blood pressure also? Could it be blood pressure spikes are a fairly frequent occurrence and that the only place it is noted is at the doctor’s office? I wonder how a doctor can determine that, even though a patient tells them the readings at the local drug store or with a home monitor are normal, that readings if they were taken in a traffic jam or at the dentist’s office or during football games, aren’t elevated also.

If the visit to the doctor’s office is just the tip of the blood pressure iceberg, it seems that there is a real chance of people with chronic blood pressure spikes running around out there not getting the medical help they should. Call me a skeptic, but if something can trigger this subconsciously in a doctor’s office it seems that you’re talking about a fairly strong subconscious.

From a life insurance standpoint well controlled, treated high blood pressure is really not a big deal. Most companies will offered preferred, if not preferred plus rates. If you are applying for life insurance and have been told that you have white coat syndrome, tell your independent agent right up front. This gives your agent a chance to do a couple of things that may help you put the syndrome in context for the insurance company.

First, your agent can let the examiner know so they might take more than the normal three readings. Often successive readings will get lower. The examiner will also know to time a blood draw so that it doesn’t impact the blood pressure readings by creating a nervous situation. Second, the agent can let the company know about your diagnosis of white coat syndrome so that they are not surprised by readings in your medical records. And lastly, you should make sure that your doctor has, in fact, diagnosed white coat syndrome and noted it in your medical records. If it isn’t addressed in your medical records the insurance companies will not buy it as a defense for high blood pressure.

Bottom line. White coat syndrome has been a real diagnosis for a long time. Whether or not I completely buy into it, if it is well tested and documented, it can be used as an affirmative defense against otherwise damaging high blood pressure readings on an insurance exam or in your medical records.

Just a personally skeptical aside. If I was told I had white coat I believe I would asked to be tested across a broad spectrum of psychologically stressful situations. I would hate to go through life merrily believing I had some subconscious quirk that elevated my blood pressure only in one situation, only to find out when I suffer a stroke talking to a mortgage banker that the issue was more wide spread than was thought.

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