Blood pressure and surgery. Do you have white coat syndrome? High blood pressure?

Posted on March 22, 2012

Blood pressure is a funny thing. 

I check blood pressure at your preop, and I have found many people who are healthy, happy 40 somethings chugging along have high blood pressure.  The thing is they don’t know it.  Or they have been told they have “white coat syndrome.” 

What is white coat syndrome?

White coat syndrome is a term for high blood pressure which only occurs in the doctors office.  The theory is visiting the doctor can be stressful.  In true cases of white coat syndrome, your blood pressure is normal all of the time- just not the one time it is checked in the doctors office. 

But

A common scenario is “white coat syndrome” high blood pressure is really true high blood pressure.  If your blood pressure is elevated when you are stressed, just think how many times a day it is zooming up.  Just ran to catch the bus? Big presentation? Someone cut you off while driving? Late to your meeting? Drank 3 cups of coffee?   

How high is high blood pressure?

The numbers have changed a bit over the years.  Ideal “normal” blood pressure used to be 120/80.  In recent times the number has been revised to 115/75 being better.

NORMAL blood pressure 115/75

PRE hypertension is 120-139 systolic, 80-89 diastolic.  It tends to get worse over time.

STAGE 1 hypertension is140-159/90-99

STAGE 2 is 160 or higher systolic, 100 or higher diastolic. 

When your blood pressure is elevated you won’t feel it. This is why when considering surgery it is a good idea to get a thorough check up from your primary doctor ahead of time.  Checking simple things like blood pressure and basic labs helps make sure your surgery is uneventful.  We want your blood pressure to be normal during surgery.  If blood pressure is high it can increase bleeding and other issues.  And if your high blood pressure has gone untreated for a while, it can be damaging to blood supply like smoking, high cholesterol, and diabetes.

So what should you do?