BACKGROUND: Blood pressure is the most ubiquitous diagnostic recording made in the doctor's office, but the measurement is subject to a number of sources of bias, which may lead to over- or underestimation. The current study examined the systematic influence of the way in which the measurements were taken - by the physician, by a nurse, or with the patient sitting alone, using an automated device. SUBJECTS AND METHODS: Blood pressure was measured in 17 essential hypertensive and 10 white-coat hypertensive individuals. On separate clinic visits, measurements were taken by the attending physician, by a nurse and using an automated device (Arteriosonde 1216). RESULTS: A repeated-measures ANOVA revealed that, for systolic pressure, there was a significant effect of measurement modality on blood pressure. Physician systolic pressures were on average approximately 10 mmHg higher than those taken by a nurse, nurse pressures being approximately 7 mmHg higher than those recorded using Arteriosonde. The effect on diastolic pressure was similar but smaller, and no nurse-Arteriosonde difference was observed. CONCLUSIONS: We conclude that the routine clinical assessment of blood pressure would be more representative of daily ambulatory pressure if an automated device, without doctor or nurse present, were used.
BACKGROUND: Blood pressure is the most ubiquitous diagnostic recording made in the doctor's office, but the measurement is subject to a number of sources of bias, which may lead to over- or underestimation. The current study examined the systematic influence of the way in which the measurements were taken - by the physician, by a nurse, or with the patient sitting alone, using an automated device. SUBJECTS AND METHODS: Blood pressure was measured in 17 essential hypertensive and 10 white-coat hypertensive individuals. On separate clinic visits, measurements were taken by the attending physician, by a nurse and using an automated device (Arteriosonde 1216). RESULTS: A repeated-measures ANOVA revealed that, for systolic pressure, there was a significant effect of measurement modality on blood pressure. Physician systolic pressures were on average approximately 10 mmHg higher than those taken by a nurse, nurse pressures being approximately 7 mmHg higher than those recorded using Arteriosonde. The effect on diastolic pressure was similar but smaller, and no nurse-Arteriosonde difference was observed. CONCLUSIONS: We conclude that the routine clinical assessment of blood pressure would be more representative of daily ambulatory pressure if an automated device, without doctor or nurse present, were used.
Authors: Nynke Scherpbier-de Haan; Mark van der Wel; Gijs Schoenmakers; Steve Boudewijns; Petronella Peer; Chris van Weel; Theo Thien; Carel Bakx Journal: Br J Gen Pract Date: 2011-09 Impact factor: 5.386
Authors: Matthew T Crim; Sung Sug Sarah Yoon; Eduardo Ortiz; Hilary K Wall; Susan Schober; Cathleen Gillespie; Paul Sorlie; Nora Keenan; Darwin Labarthe; Yuling Hong Journal: Circ Cardiovasc Qual Outcomes Date: 2012-05-01
Authors: Daichi Shimbo; Sujith Kuruvilla; Donald Haas; Thomas G Pickering; Joseph E Schwartz; William Gerin Journal: J Hypertens Date: 2009-09 Impact factor: 4.844
Authors: Gbenga Ogedegbe; Thomas G Pickering; Lynn Clemow; William Chaplin; Tanya M Spruill; Gabrielle M Albanese; Kazuo Eguchi; Matthew Burg; William Gerin Journal: Arch Intern Med Date: 2008-12-08
Authors: Paul A Fishman; Melissa L Anderson; Andrea J Cook; James D Ralston; Sheryl L Catz; Jim Carlson; Eric B Larson; Beverly B Green Journal: J Clin Hypertens (Greenwich) Date: 2011-09-13 Impact factor: 3.738