Second opinion?

White coat syndrome is not high blood pressure if your readings at home are normal. This doesn't sound like a cardiologist to me. I suggest you find one. You can wear a 24 hour blood pressure monitor and a determination will be made based on those results, it's the best way to determine blood pressure issues when anxiety spikes occur. I have had some fairly alarming anxiety spikes and two separate cardiologists told me the occasional spike doesn't warrant increasing my blood pressure medication since it is normal when I take it twice daily at home (upon waking and at night). Overmedication can have serious results, like passing out for instance. My recently acquired primary care physician (actually a nurse practitioner, this is a very busy practice unfortunately) told me several times she was afraid I was going to have a stroke because in office BP was elevated. Elevated BP doesn't cause strokes, they can be a symptom of one, but she scared me so badly I harrassed by cardiologist with my health anxiety over this and actually acquired OCD about it. I found a very good cardiologist closer to where I live and he said the exact same thing the one at the teaching hospital (an hour away) told me. Occasional high spikes are "largely benign", it's walking around with sky high BP all the time that requires more medication. Neither one of these doctors see any reason to require any further heart testing based on my in office elevated pressure (that isn't constant, sometimes it's ok there), no 24 hour BP monitor, etc. You need to find another doctor who understands the mechanism of hypertension. You don't want to take medication you don't need. You won't drop dead suddenly from elevated blood pressure so it's worth finding a cardiologist for a specialist's opinion.