white coat blood pressure effect
 

hello,
does the white coat effect disqualifying a pilot from gretting a first class medical,and by what mean we can revoke the decesion of unfit due to this effect by authority.thanks

Hi fo1986
Not a pilot nor a medical professional but I had this problem in an earlier life.
There's a thing called IIRC an Ambulatory Sphygmomanometer which you wear for 24 hours. It records your BP, pulse etc half hourly during the day and hourly at night. I have used one twice and each time the highest readings were recorded in the clinic when it was fitted and removed.

Can't say if this is acceptable to the relevant authorities but I'm sure there will be someone along soon with a more professional answer for you.

The 24 hour monitor is perfectly acceptable and is a true indication of underlying blood pressure.

It's much more reliable than a single reading in a doctor's room.

Any doctor worth his salt would look at a 24 hour monitor before confirmation of real hypertension.

sorry but i have not understood,does it mean if the doctor confirms that it is just a white coat effect and no hypertension ,i mean permanent hypertension,there will be no problem,or in fact white coat effect is a cause of pilot loss of medical.thanks

If the AME can determine it's white coat syndrome, no problem. In my experience they will however want to get your blood pressure within reasonable limits during your examination. This is normally via diversionary tactics or checking it later in the examination when hopefully you've calmed down a bit.

If it's permanent hypertension then obviously that requires further investigation...

docs are very familiar with high BP readings from stressed first time patients
here in australia, its called the first time with new doctor reading

a surprisingly easy way to calm down is to relax the muscles and breathe deep and slow

have a look on the NICE website (hypertension-diagnosis.):)

quick guide here http://www.nice.org.uk/nicemedia/liv...6015/56015.pdf

My other half has a long-standing but controlled condition that requires frequent check-ups, including BP. Her GP (he prefers the term family doctor) always goes for 'best of three' if the first test isn't where he thinks it should be. It always works.:)

I had a discussion about this with an eminent physician from Mumbai regarding this white coat syndrome and he said that it just a temporary rise in blood pressure and it not require any medication and as far as concern to fitness, this kind of blood pressure considered as normal phenomenon.

Pistol shooters in competition slow their heart rate. Oddly, to get the sight-picture they need, the weapon is often held at arms length and the pulse can clearly be seen on the tip of the barrel. Minute, but it's there. I could calm mine, but it was claimed one chap stopped his heart during the last fraction of the pull. I seem to remember he was wired as a medical curiosity, not by the shooting fraternity.

I know one guy who takes two standard aspirin 90 minutes before his blood pressure check...it helps him. I am not a doctor...good luck.

My AME suggested that I keep a BP spread-sheet using a home monitor to send him.
Allowing for the differences in the machine my BP was always well within limits; I think I too suffer from the stress of getting to examination room and as you indicate 'white-coat' syndrome.

Most pilots take one look at at a doctor and go into a blood pressure spiral. To much hanging on the outcome. Most aviation doctors are more than aware of the pilots apprehension and take it into account.

I suffer (very) badly from White Coat Syndrome. At my last medical my BP was 185/84! Result - "Temporarily Unfit".

A 24 hour BP test conducted two days later showed an average of 130/73 with a peak of 150 systolic and 91 diastolic. Result - "Fit - Unrestricted"