Difference in blood pressure, but not in heart rate, between measurements performed at a health centre and at a hospital by one and the same physician

Abstract

Background: Blood pressure (BP) has been found to vary between examiners, for example it is often higher when measured by a physician than by a nurse. Whether the location for the physician-measured BP is also a source of variation has, however, not been studied. Hence, we found it of interest to find out if the location used for examination was of any significance. Objective: To explore if BP and/or heart rate measured in the same subjects by the same general practitioner in the health centre and at the hospital, differed. Method: Twenty-five hypertensive and 25 age-matched normotensive middle-aged men had their office BP and heart rate recorded by one and the same female general practitioner (IE) who was well known to them, at both the health centre before ambulatory BP equipment was attached to the subject and at the clinical physiological department before an exercise test. The hypertensive patients performed an exercise test and ambulatory BP was measured before and after being treated. Results: The hypertensive patients' office BP was lower at the health centre than at the hospital, both when they

Intraocular Pressure Reactivity to Social Stressors

“…As in the case of white coat hypertension (MacDonald et al, 1999; O’Brien et al, 2003), OWCH could be mediated by the degree of perceived control and threat related to the clinical context and the invasive and aversive properties of the measurement procedure. And similar to what has been found when measuring blood pressure (Enström, Pennert, & Lindholm, 2000), there may be an increased physiological arousal induced by certain contextual variables involved in the IOP assessment procedure in clinical contexts that could be judged as stressful by the patient (due to, for instance, the invasion of personal space, uncertainty regarding health status, or the presence of the clinician). This could induce artificially high IOP levels, which could lead to an overdiagnosis (due to false positives) of glaucoma.…”

Janus faces of the white coat effect: blood pressure not only rises, it may also fall

“…4 In a study where one doctor measured the patients' blood pressure both in a primary health centre and at a hospital, the hospital readings exceeded by 9.4/6.0 mmHg (systolic and diastolic BP) the health centre readings. 5 Thus, the BP of hypertensive patients seems to vary depending on the environment and the measurer.…”