What can cause high blood pressure in a pre-medical evaluation?

Assuming that you do not normally suffer from high blood pressure, there are still several factors that might cause your blood pressure reading to be high during a pre-medical evaluation. A blood pressure test records systolic and diastolic pressure. Blood pressure readings are reported as an upper and lower number, measured as millimeters (mm) of mercury(Hg). A normal, adult blood pressure reading should be around 120/80 mmHg. The upper number refers to the systolic or active pressure while the lower number refers to the pressure at rest.

Systolic blood pressure is the flow rate of blood being pumped through the body. Diastolic pressure is the level of pressure as blood flows back to the heart. Temporary environmental, emotional, or physical factors may cause your blood pressure reading to vary by as much as 50mmHg.

One of the most common causes of temporary high blood pressure is stress. During stressful situations, your body reacts by releasing hormones that instruct your body to prepare for fight or flight. These hormones cause your blood vessels to constrict and your heart to beat faster. This raises the peak flow of blood being pumped by the heart, increasing your systolic blood pressure reading.

Sometimes, the very fact that you are in a doctor’s office or having an exam will trigger sufficient stress to raise your blood pressure. This effect is so common that is has been given a name, “white coat syndrome.”

Other factors that may cause you to have a high blood pressure reading at your pre-medical evaluation include the physical setting and conditions of the exam, and your activities and behavior before and during the exam.

For instance, if the blood pressure cuff is too small or placed over your clothing, this can affect the blood pressure reading. If your blood pressure is being measured in a room that is cold, you have a full bladder, or you are not sitting in a comfortable position your reading may indicate a higher than expected systolic pressure.

Your lifestyle and behavioral factors may also temporarily increase your blood pressure during your exam. These include smoking, or consuming caffeine or alcohol prior to being tested. Avoiding alcohol, caffeine, and smoking for at least 30 minutes prior to your blood pressure test will help you get a more accurate reading.

In addition, your blood pressure may be elevated if you have not rested for at least a few minute before the test. Engaging in activity increases your heart rate, so to get an accurate reading you should wait until you are relaxed. Even talking while your blood pressure reading is being taken may increase your blood pressure by up to 15 mmHg.

Hypertension, or high blood pressure, can have long-term health consequences if not treated. If you have an unexpectedly high blood pressure reading during your pre-medical evaluation, you may wish to consider whether any of the above factors could have played a role. If retesting reveals that your blood pressure is consistently high, you can then discuss how to lower your blood pressure with your doctor.