I have the same problem. One thing I started doing is monitoring my bp at home just to prove to myself that I don't have a problem. While doing this I practice using different arm positions and breating rates to get the lowest reading possible. This seems to help me be more relaxed at the AME office. Also, I've noticed that I always test higher on a digital machine, with this in mind I always ask for the non-digital type with a large cuff. And lastly, I always do an intense workout approx. 2 hours before my appointment. BTW despite having the "white coat syndrome" I have been getting 1st class medicals for the last 20 years. Hope this helps!!