There's a fine line between a white coat effect, and actually having high blood pressure and you need to be honest in your self assessment. At an absolute minimum if you are chalking up high BP in clinic visits to a white coat syndrome, you should be checking your blood pressure at home and keeping a log so that you have an honest assessment of what your BP is really doing over your work, home and play environments.
You'll probably discover a few things, like your BP is usually higher in the morning. It's counter intuitive but it is what it is. It'll also cue you in about other things that might make your BP rise. Some folks get upset in traffic and that'll increase BP. If you start to see patterns in what raises your blood pressure, it'll pointing a giant flashing arrow at some potential lifestyle changes you need to make. Some are simple, like just not choosing to get upset when someone cuts you off in traffic. Others are much more difficult, like diet and exercise, or perhaps changing to a lower stress job or career.
Over time you'll also note longer term changes that may also suggest you need to get on an exercise program, start eating right, taking off extra weight, etc. Getting older generally means your metabolism starts to slow down and you just can't eat like you did when you were younger. It also means you have to make a point to exercise - and it helps if you can find exercise activities that you enjoy, that also don't beat you up.
Now...here's where I'll stray from the herd a bit. My wife is a nurse and she's a "med" person, and a good counterbalance to my general preference to not use meds unless other more conservative approaches don't work. But unfortunately, those more conservative approaches require a lot of motivation and self discipline. We live in America, where we prefer our fixes to be quick and easy and high blood pressure meds are by and large quick and easy fixes. The doctor will suggest diet and exercise, and perhaps some lifestyle changes - and then prescribe meds because he or she knows compliance with a diet and exercise program as well as life style changes will be low.
However, that's also putting a bandaid on the problem rather than addressing the underlying issues. So if someone is on BP meds and is overweight, and/or working in a high stress job, and/or has a raving type A personality - and isn't willing to address those issues and make constructive changes - BP meds will just extend the glide farther to the inevitable stroke or heart attack.
