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If you have a little greyhound in you beware of white coat syndrome

Posted by Dr Sandy on in Heart disease | 921 Views | Leave a response
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greyhound under pressure in front of the vetAs I step into the doctor’s consulting room my heart starts to race. By the time his cold hands have wrapped the blood pressure cuff round my arm and the air begins filling the cuff and cutting off the blood supply, my heart is at fever pitch.

Surprise, surprise – the blood pressure reading snaps back a very embarrassing, almost life threatening number.

Yes, I suffer from white coat syndrome. Ironically, it is not just doctors in white coats that manage to get my heart in a flat spin, even the poppies at the gym get a rise out of it. A better description of my condition is ….   I am allergic to public blood pressure meters.

Turns out white coat syndrome is not only a problem for highly anxious humans (like me), but a problem for highly anxious dogs.

Greyhounds go grey

Well that is the colour they would be, if their systolic blood pressure was really 300 mmHg, as suggested by the meter readings. Dog normal is 120 mmHg, in trouble 180 mmHg – 300 mmHg is DEAD.

Greyhounds are considered a high strung breed and seldom register “normal” readings when visiting the vet. But based on research carried out by students at Ohio State University College of Veterinary Medicine, the blood pressure reading is reflecting the animals state of angst, rather than their blood pressure.

In this study blood pressures of a group, 22 in total, of retired racing greyhounds was monitored. When the animal’s blood pressure was taken by the vet, at the veterinary clinic, the blood pressure spiked a wopping 30 points, compared to the reading taken at home.

Sometimes the number dipped at the clinic, provided the animal was given plenty of time to adjust to the horror of being at the vet.  A lot of the time the animal never adjusted.

Problem not the vet, but the clinic

The problem was not the vet but the clinic.

At the clinic it was high.  At home, even when the “vet” pitched up wearing all the gear (scrubs), the blood pressure was still lower than that recorded at the clinic.

Environment counts for greyhounds (and humans)

The greyhound study emphasises the need to consider the environment in which blood pressure is measured, before diagnosing or eliminating hypertension.

What is true for greyhounds is also true for humans.

High blood pressure is a big deal, it is one of the three killer factors for a cardiovascular event i.e. a heart attack or stoke. If you have high blood pressure you need to get it down, whether you use drugs, supplements, exercise or diet BUT…….

Verify you really do have high blood pressure

Officially high blood pressure should only be diagnosed if it is high on three separate visits to the doctor / clinic.

But, using this guideline might not be all that helpful, if you’ve got a little greyhound in you i.e. a type A personality. So you need a plan B.

  • One option is to ask the doctor to wire you up, so your blood pressure can be monitored over a 24 hour period – it may work, it might not. I’ve tried it, the only time my blood pressure dropped anywhere near normal, was when I fell asleep, and since I was so worked up about carrying the giant size box round with me, I actually didn’t catch too much shut eye anyway.  Lack of sleep is a recipe for high blood pressure.
  • Another option, and the one that I recommend, is purchase or borrow a device that allows you to measure it at home. Take your blood pressure regularly, at different times of the day and just jot down the numbers, then  share this data with your physician each time you visit.

Verify your level is really a problem

The red flag numbers…….

  •  If your older than 50, the first number (systolic blood pressure) should not be above 140 mmHg.
  •  If your less than 50, the second number (diastolic blood pressure) should not be above 100 mmHg.

If your numbers are lower than this,  the benefit you’re getting from the medication probably does not outway the “risk”.

White coat syndrome no laughing matter

Don’t let the fear of the doctor drive you nuts, crack open a packet of nuts  and LOL (laugh out loud).

White-Coat Effect on Systemic Blood Pressure in Retired Racing Greyhounds. Journal of Veterinary Internal Medicine 2011; 25 (4): 861- 865.  C.L. Marino, R.E. Cober, M.C. Iazbik, C.G. Couto.    Impact of Diastolic and Systolic Blood Pressure on Mortality: Implications for the Definition of ‘Normal’. Journal of General Internal Medicine (2011) 26(7):685-690.   Brent C. Taylor, Timothy J. Wilt, H. Gilbert Welch.
 

Further reading

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Posted in Heart disease | Tagged anxiety, blood pressure, cardiovascular, dogs, heart attack, hypertension, stroke, white coat syndrome

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Located in Johannesburg, South Africa

Disclaimer : The stories and articles are provided as a service. Dr Sandy's opinions are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
 

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