Are You Anxious About the Vaccine or the White Coat?

White coat hypertension, or white coat syndrome is something many are all too familiar with. On average, the prevalence of white coat hypertension (WCH) is around 10-15% of the general population. For those that may not be familiar, WCH is a condition whereby patients experience elevated blood pressure when they are in the presence of a doctor or other medical professional.

When not in the presence of a ‘white coat’ or healthcare professional, these same patients exhibit normative blood pressure levels. It is specifically the presence of a medical professional, or ‘white coat’ which triggers the rise in blood pressure.

But why is this important?

The pandemic has engendered among other things, an increased interest in public health. And for good reason. COVID-19 has illuminated public health issues around the globe. From increased awareness of measures to help prevent the spread of pathogens—such as isolation, contact tracing, wearing a mask, and social distancing—to increased attention on the importance of reliable medical guidance, we are more vigilant to these topics than we were pre-pandemic.

Many are also more mindful of their own health. While the pandemic has resulted in a decrease in many doctor’s visits, such as routine checks for skin cancer, millions around the globe are still making their visits to wherever they may find a medical professional to receive their COVID-19 vaccines.

The landscape of the ‘doctor’s office’ may have changed, but the presence of the white coat in many cases, has not. Whether individuals are receiving their vaccines at drive-through vaccine clinics, sports stadiums or athletic centers, the simple association of a medical professional with anxiety is still a threat for many.

This association of a medical professional with anxiety is often an unconscious one. Even for those who are aware of their anxiety, a resultant spike in blood pressure can be triggered whether they are conscious of the trigger or not. This is in part due to the nature of the autonomic nervous system (ANS).

The ANS is a part of the body’s nervous system which regulates body processes such as heart and respiratory rate. The autonomic nervous system acts largely unconsciously in its regulation of processes.

You do not have to directly ‘tell’ your lungs and associated physiological components to breathe, nor do you have to tell your blood to pump through your veins. This is probably for the best, given many have enough to remember to do in a day. The body helps make living that much easier by automating these essential functions that help keep us alive.

While the ANS operates mostly on an unconscious level, certain mechanisms can be influenced through conscious activity such as changing the rate at which you breathe. Making a choice to slow the rate at which you breathe, for example, may help to decrease your heart rate. This in turn sends signals to your body to help the body relax, which may be helpful in reducing anxiety.

The ANS is split into two components: the sympathetic and the parasympathetic nervous system. The former triggers the fight-or-flight response, which provides the body with energy to help respond to a perceived danger. For those with white coat hypertension, this means a spike in blood pressure to help respond to the perceived threat of the white coat.

Whether the triggering factor is in fact a real danger or not doesn’t matter much. We may consciously know that doctors and other medical professionals are there to help us, but the perceived danger and subsequent anxiety may remain.

As with many medical conditions, awareness of your condition is the first step to helping maintain control. If you find yourself a tense during that visit to get your first or second dose, a few deep breaths may help ease the tension. As always, speak with your doctor to ensure you have the right solution based on your specific health needs.

About Dr. James Goydos

Dr. James Goydos is an expert in melanoma research and specialist in surgical oncology with an M.D. from Rutgers University. With over 20 years of experience as a Professor, Surgeon, and Clinical Trial Lead, he is a leading expert in his field.

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