Blood Pressure Determinations by Patients With Essential Hypertension

Ayman, David; Goldshine, Archie D.

doi:10.1097/00000441-194010000-00005

Cited by 263 publications

(12 citation statements)

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“…Most of the studies which have been carried out amongst non-pregnant patients have shown that clinic blood pressure measurements are higher than domiciliary measurements [1,9,10,12]. This phenomenon has been attributed to 'white coat hypertension ' [11] and has been elegantly demonstrated by MANCIA ET AL [8].…”

Section: Discussionmentioning

confidence: 99%

No difference between home and clinic blood pressure measurements in pregnancy: A computerized telemetric study

Mooney¹,

Jaspar²,

Cartwright³

et al. 1991

Jpme

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Many decisions in pregnancy are based on one or two casual blood pressure estimations made in the antenatal clinic. No previous study has challenged the validity of this practice or attempted to discover whether there are significant differences between the blood pressures of pregnant women when they are measured in the clinic and when they are measured in their home environment. We measured the blood pressures of 35 healthy pregnant women both at the antenatal clinic and in their own homes. All the women were at between 28 and 32 weeks gestation. At both locations, ten consecutive blood pressure and pulse measurements were made at one minute intervals using a Dinamap 1846P automated blood pressure monitor. The readings taken in the clinic were supervised, whilst at home the patients used our blood pressure telemetry system without direct supervision, the results being transmitted automatically to the hospital computer via the public telephone network. The Dinamap results were analysed in detail. Each ten minute recording session was summarised in terms of the first, last, highest, lowest and mean of the systolic, diastolic and mean arterial blood pressure, and pulse measurements in that session. Also, two measures of the variability within a ten measurement series were considered, the average change in pressure or pulse from one reading to the next, and the difference between the highest and lowest readings of pressure and pulse in the series. All descriptors of the clinic and the home measurements were compared using the paired Student's t-test. Clinic and home blood pressure measurements were not significantly different from each other in any respect.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

No difference between home and clinic blood pressure measurements in pregnancy: A computerized telemetric study

Mooney¹,

Jaspar²,

Cartwright³

et al. 1991

Jpme

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“…I n 1940, it was recognized in human patients that values for blood pressure (BP) measured in a clinical setting were higher than those observed at home. 1 This increase has been referred to as the white-coat effect. [2][3][4][5] Although the physiologic cause of the white-coat effect is not precisely known, it is thought to be an alerting or defense reaction involving the sympathetic nervous system in response to the stress associated with the clinical setting.…”

mentioning

confidence: 99%

Evaluation of the White-Coat Effect in Cats

1999

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The diagnosis and management of systemic hypertension in cats requires a reliable method for measurement of systemic arterial blood pressure (BP) in clinical patients. Unfortunately, the setting of a clinical practice and the act of measuring BP might raise BP and heart rate (HR), an effect referred to as the white-coat effect in human patients. The purpose of the present study was to determine if a white-coat effect was experienced by cats. Radiotelemetric implants were used to measure BP and HR in 13 conscious cats in a research colony while undisturbed in their cages and while subjected to simulated visits to a veterinarian's office. The white-coat effect was taken to be the difference between the overall 24-hour average value for parameters of BP and HR and the corresponding value during the simulated office visit. A white-coat effect was observed in cats. In healthy cats, the systolic BP measured during the examination period of the simulated office visit exceeded the 24-hour average systolic BP by 17.6+/-1.5 mm Hg. However, marked heterogeneity occurred in the pattern and magnitude of the increase in systolic BP above the 24-hour baseline and the increase varied between 75.3 and -27.2 mm Hg for the healthy cats. Variation in response to the simulated office visit was observed among cats and among visits by the same cat. During an office visit, the magnitude of the white-coat effect tended to decrease, but not disappear, over time. The magnitude of the white-coat effect varied when cats were subjected to 5 repeat office visits, but did not diminish in the group as a whole. The mean increase in systolic BP during the examination (22.3+/-0.9 mm Hg) was greater (P < .05) in cats with renal insufficiency. Although the heterogeneity of response expected from companion animals might be greater than that observed in these colony cats, these results indicate that veterinarians should carefully consider the white-coat effect in evaluation of BP in cats. A quiet, undisturbed environment and adequate time for acclimation should be included in the standard protocol for measurements of BP. Because of day-to-day variation in the white-coat effect in individual cats, multiple serial measurements following a standard protocol should provide the best estimate of BP in cats.

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“…This may be in part remedied by repeating the observation toward the end of the visit (19) or by having a nurse or a technician make the measurements in the doctor's office (8). Alternatively measurements may be made a t home by the patient (1,2,4,5,20,21) , or by ambulatory blood pressure recorders over a prolonged period of time (3,7,11,13,22,23).…”

Section: Discussionmentioning

confidence: 99%

“…However, blood pressure measur'ements made by a physician may trigger an alerting reaction that is responsible for a transient rise in blood pressure (1)(2)(3)(4)(5)(6). This rise can lead to a misdiagnosis of hypertension, the so-called "white-coat" hypertension or "office" hypertension ( 3 , 7 ) , and to improper decisions about when and how much to treat.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Ambulatory Blood Pressure Monitoring During Clinic Visit in Elderly Hypertensive Patients

Shimada¹,

Ogura²,

Kawamoto³

et al. 1990

Clinical and Experimental Hypertension. Part A: Theory and Prac

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The pressor response to blood pressure measurements in a routine outpatient clinic setting has not been adequately characterized. Blood pressure was monitored in 104 hypertensive patients, mean age of 62 years, by noninvasive automatic ambulatory monitoring device at 5 minutes interval throughout the time of their visits to our outpatient clinic. The average rise in systolic and diastolic blood pressures upon patients' visit to doctor's room was 17 and 7 mm Hg respectively. There was concomitant tachycardia (average rise 3 beats/minute). The rise in blood pressure and heart rate was significantly related to the value in the doctor's room, but was not related to either age, the value in the waiting room or treatment. The rise in systolic blood pressure was more prominent in female patients than in males. Blood pressure and heart rate returned to the baseline level by approximately 40 minutes after leaving the doctor's room. These results illustrate a transient rise in blood pressure during measurement by a doctor in an outpatient clinic. Noninvasive ambulatory blood pressure monitoring during clinic visit in hypertensive patients may be a potentially useful and convenient method for the better diagnosis of hypertension by abolishing the alerting reaction.

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Blood Pressure Determinations by Patients With Essential Hypertension

Cited by 263 publications

References 0 publications

No difference between home and clinic blood pressure measurements in pregnancy: A computerized telemetric study

No difference between home and clinic blood pressure measurements in pregnancy: A computerized telemetric study

Evaluation of the White-Coat Effect in Cats

Noninvasive Ambulatory Blood Pressure Monitoring During Clinic Visit in Elderly Hypertensive Patients

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