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Dealing With White Coat Syndrome

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If you're about to take your Taxi and Limousine Commission, also called the TLC physical exam, plan carefully. A high blood pressure reading can restrict or even temporarily cancel your certification to drive. Unfortunately, it's common to find your blood pressure rising in the doctor's office, resulting in a temporarily high reading due to something called white coat syndrome. This is a condition in which your blood pressure goes up when you're in the doctor's office (the name "white coat" comes from the white lab coats often worn by doctors), resulting in an abnormally high reading that isn't representative of what your blood pressure is really like. By planning your schedule well and taking a few extra steps, you can reduce your chances of getting caught in the white-coat web.

Arrive Early

White coat syndrome itself doesn't necessarily always result in high blood pressure readings; it results in a rise in blood pressure period. While it's possible that rise will put you in high blood pressure territory, it's also possible that the rise itself won't be bad and you'll still be in a normal range. In other words, your blood pressure could rise, but your regular pressure could be low enough that the rise doesn't make you look like you actually have high blood pressure. However, other factors could combine with the rise due to white coat syndrome. If you run into your doctor's office from the parking lot, are barking at someone on the phone, and are generally not calm, that, in and of itself, could make your blood pressure go up temporarily.

To avoid that combination, leave early for your appointment. Leave enough time for the trip to be rather leisurely. Don't let traffic get to you, and take the elevator when you get to the building, if you have to go to an upper floor. If you do take the stairs or walk a long distance, give yourself several minutes before the appointment to simply sit and relax.


Meditation can calm you down if you're nervous about your appointment (and nerves can make your pressure go up). So, give breathing and clearing your mind a try before your appointment. Just steady your breathing and remind yourself that this is a routine physical, and then try to just sit quietly and think of as little as possible.

Take Blood Pressure Again or Later

It's typical to have your blood pressure taken at the beginning of the appointment; if you're nervous about a rise in numbers due to white coat syndrome, tell the doctor and ask to have your blood pressure test repeated later in the appointment, or ask to have it taken at the end of the appointment instead of the beginning. At that point, you might be more relaxed since the appointment will be almost over.

If you still end up with a high blood pressure reading, you do need to investigate it, even if you think it's due to white coat syndrome. If you need more guidance on how to handle high blood pressure, or if you still think your high reading is due to white coat syndrome, talk to your doctor and to the doctor who examined you for the TLC physical. They'll be able to help you find the best course of action that will allow you to remain on the road.