My home blood pressure monitor always gives me readings in the normal range, but when I go to my doctor, the readings are 160/90, or higher. I think I have white coat hypertension, but how can I be sure?

There is indeed a good chance that you are one of many people whose blood pressure rises mainly when they are in the physicians office, and you are smart to want to know for sure whether or not you have this condition. If your blood pressure is only elevated when you go to the doctor, then you really are not at any increased risk for the complications of hypertension and so are unlikely to benefit from medications. On the other hand, if your blood pressure really is high, you can reduce your risk of stroke and heart disease by controlling this condition.

There are two strategies that you and your doctor should consider.

First, at least once per year take your home blood pressure monitor with you when you go to the doctor.

Then you can check the blood pressure measurement obtained with your device against the doctors reading. If they are within a few points, then you can relax — the blood pressure measurements you have been taking at home appear to be accurate.

On the other hand, if your device gives a much lower reading than the office device, then you have been getting false reassurance. (If the numbers disagree, the machine can usually be recalibrated without much difficulty.)

A second strategy is to have your blood pressure checked over a 24 hour period using an ambulatory blood pressure monitor -- a device that is worn on your belt or in a harness for a full day. It checks your blood pressure every few minutes and gives a true picture of whether your blood pressure is usually normal or frequently surges into higher ranges.

I am undergoing treatment for hypertension and have been taking 200 mg of vitamin E daily for the past few years. I read that even lower doses might raise my risk of having a hemorrhagic stroke. Is this true?

With respect to your risk of getting a stroke, I can only say the obvious: make certain that your antihypertensive treatment is keeping your blood pressure in the normal range.