When your doctor takes your blood pressure (BP), is it higher than the normal 120/80? Since you always get nervous in a medical setting, you assume that you have a classic case of white coat hypertension. You’re convinced that your BP only spikes when you’re at the doctor’s office and, therefore, you can ignore this reading. According to Dr. Ami B. Bhatt, Medical Director of the Massachusetts General Hospital Adult Congenital Heart Disease Program, that could be a mistake. “White coat hypertension is not isolated. It’s an indication that when you’re in a stressful situation, like sitting in traffic, or with three kids who won’t keep still during dinner, your BP could be rising,” she said.

Blood pressure measures the force exerted by the blood against the artery wall.

Higher than normal blood pressure is dangerous because it can injure the inner lining of an artery, creating the formation of plaque, and setting the stage for a future heart attack or stroke. High blood pressure also overworks the heart, kidneys and other organs which, overtime, can result in damage.

Dr. Bhatt, who specializes in cardiology for adolescents and young adults, notes that many people in their 20s and 30s assume that heart disease is a problem that primarily impacts people in their later decades. “What they don’t realize is that a heart attack doesn’t happen overnight. Most people who have a heart attack at 60 started injuring their arteries and developing plaque when they were younger.” Importantly, Dr. Bhatt points out that even calm, relaxed people without major life stress can have high blood pressure.

If you have so-called ‘white coat hypertension,” or have been diagnosed with high blood pressure, Dr. Bhatt feels that monitoring your BP on your own at home with a blood pressure tracker could be a useful tool in helping you better manage your condition. “Tracking your BP at home can be very useful in terms of helping you see how your actions can impact your blood pressure. For example, if you watch your salt intake for a few days, you may see a drop in your BP, or it could respond well to a good workout. If your doctor told you that if you lost ten pounds you could reduce your blood pressure, and you see it on your BP tracker, it’s great reinforcement.”

According to Dr. Bhatt, whether or not you have high blood pressure, or are at risk for developing heart disease (like people with diabetes or a strong family history of heart attack or stroke), it makes sense to keep known risk factors under control. “Basically, it’s important to maintain normal BP, stay at a healthy weight, make sure that your cholesterol levels are normal, avoid smoking and get enough aerobic activity. This is good advice for everyone, but it’s especially important for people who are at higher risk.”

At the end of the day, managing stress is maybe the hardest risk factor to control. Dr. Bhatt likes the American Heart Association’s recommendations which include positive self talk (‘this is not what I wanted but I can handle it’), emergency stress stoppers (10 deep breaths), finding pleasure and daily relaxation. “Most young adults spend so much time taking care of others that they forget about themselves,” says Dr. Bhatt. “But a little attention to our own health when we are young will go a long way when we get older.”