This weeks question comes from Alison L, in Brooklyn N.Y. White coat syndrome can be very annoying to deal with. Even the thought of a doctors visit can cause your blood pressure to be higher then normal. “I swear it is not that high at home!” you say to your physician as they peer at you over you with their spectacles. I hate that look, always reminds me of my dad when I did something he did not like.

So what can we do to avoid white cost syndrome? Here are a few tips:

Step 1

Breathe deep for 15 minutes before testing. Shallow breathing increases blood pressure. Deep respiration requires more exhale than the inhale. Inhale through the nose, holding the count to five or six seconds. Let the abdomen expand, rather than the chest, and exhale through the mouth one second longer than the inhale.

Step 2

Drink 20 oz. of beet juice. Beet juice contains nitrate, a component that dilates blood vessels and increased blood flow. Participants in a study conducted by St Bartholomew’s Hospital in London showed a decrease in blood pressure in less than one hour after drinking 20 oz. of beet juice. In 2.5 hours, the participants saw a significant reduction in blood pressure.

Step 3

Take a brisk walk for at least 15 to 20 minutes. While at least 30 minutes of physical activity five days a week can reduce blood pressure overall and is effective for managing hypertension, a patient may not have the time necessary for regular exercise to have a significant effect on blood pressure before a test. However, even a short walk produces rhythmic breathing, which decreases blood pressure by calming the body’s stress response. Moreover, the extra oxygen increase helps the heart use oxygen more efficiently, thereby decreasing the stress or pressure on the heart.

Step 4

Drink a glass of water. Water has a calming effect on the nervous system, and water flushes out sodium, an element that increases blood pressure. Drink a larger portion of water at one time, rather than sipping on water at several intervals during the day. Sipping water throughout the day is good for staying hydrated, but for a faster effect on blood pressure, drink a glass of water for direct calming effects and a drop in blood pressure.

Step 5

Eat a banana or other potassium-rich food. Potassium is an electrolyte, and plays a significant role in some of the mechanisms that control blood flow and heartbeat. Potassium supplements may take four to six weeks before having an impact on blood pressure. Depending on how fast the body metabolizes the foods rich in potassium, blood pressure may drop within an hour or two of eating a potassium-rich food. See Resources for a list of potassium-rich foods.

Step 6

Avoid unhealthy foods and habits before visiting the clinic for testing. Refrain from smoking at least one hour before the appointment, as smoke decreases oxygen intake and makes the heart work harder. Avoid fatty meals, which often contain lots of sodium and increase blood pressure, at least two days before the physical.

Step 7

Take a nap before testing or visiting the clinic. Research conducted at the Liverpool John Moores University in Liverpool, U.K., found that naps reduce strain and pressure on the heart. Take a nap, no longer than one hour long, before an appointment for testing.

Step 8

Avoid making a morning appointment and tell the clinician about testing anxiety. Morning hypertension is common, as blood pressure is higher in the morning. Many patients experience a white-coat syndrome, where blood pressure may increase at a doctor’s office beyond its normal level.


Some of the antidotes used for short-term use may yield long-term results if used regularly. Patients who show borderline hypertension–a reading that is just over the threshold of ideal– may still get a passing score. Results of any testing do not automatically authorize or reject a candidate. The board that oversees the candidate’s application, such as an employer or a school athletic department, can usually qualify a candidate by reviewing the application as a whole.

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