Why Does My Blood Pressure Go Up During Doctor's Visits?

I take my blood pressure at home and it’s usually normal, but when I go to the doctor it’s high. What’s going on, and what can I do about it?

This is called “white coat hypertension,” and health care providers see it all the time. It happens when a patient’s blood pressure temporarily rises while they’re in a medical setting and goes back down to normal once they’re no longer in that environment. An estimated 15 to 30 percent of people who get a high blood pressure reading at the doctor’s office actually have a normal reading at home.

A number of reasons can account for why your blood pressure increases when you’re in the doctor’s office. For instance, you might be worried there’s something wrong with you, or you may have had a childhood experience with a health care worker that was unpleasant.

Interestingly, one of the first things that happens during a doctor’s visit is a blood pressure test. It’s standard procedure, but when patients are already nervous and that cuff goes on, their pressure can go up. My father, who was also a doctor, used to write notes in his patients’ charts if they had white coat hypertension, such as “Talk to this patient before taking BP.” 

Ask Dr. Adam

Adam B. Rosenbluth, M.D., is an internist and cardiologist in New York City. Each Monday, he’ll weigh in on your questions about how to make your body work better for you. His AARP book will be published in 2027. Join in on the conversation on social media @dradamrosenbluth to learn to move the needle on your personal health in an achievable way.

Email your questions for Dr. Adam to dradam@aarp.org

Along with chatting with them, I have my own ways of calming anxious patients. For instance, I might suggest an exercise in mindfulness. Before putting the cuff on, I’ll say something like, “Close your eyes … and let’s take a nice deep breath together … in through your nose and out through your mouth. Listen to the sound your breath is making.” My staff and I also take a few readings at different times during the appointment.

You don’t want to take high blood pressure lightly. Hypertension is called a “silent killer” because even though you may not feel unwell, the condition can lead to serious events such as a heart attack or stroke. The good news is that these days it’s easy to keep track of your blood pressure at home. You can buy a relatively inexpensive monitor in most drugstores. Some pharmacists will take your blood pressure free of charge.

In general, blood pressure goes up as we get older because our arteries become stiffer and less elastic, and our heart has to pump harder. These conditions raise blood pressure. That’s why I want to be repeat that it’s never a good idea to assume a high blood pressure reading is nothing to worry about.