Hypertension, Vol 9, 209-215, Copyright © 1987 by American Heart Association
G Mancia, G Parati, G Pomidossi, G Grassi, R Casadei and A Zanchetti
Blood pressure was monitored by a continuous intra-arterial recording in 46
subjects to investigate whether the alarm reaction and the blood pressure
and heart rate increases that occur during cuff blood pressure measurement
made by a physician 1) attenuate when the physician's visit is repeated
several times and 2) are less pronounced if a nurse measures the blood
pressure. In 16 subjects the peak mean blood pressure and heart rate rises
that occurred in the early part of the physician's first visit (22.6 +/-
1.8 mm Hg and 17.7 +/- 1.7 beats/min) were virtually identical to those
occurring during three subsequent visits by the same physician throughout a
2-day intra-arterial blood pressure monitoring. The less pronounced pressor
and tachycardic responses observed in the last part of the physician's
visit also were virtually identical among the four visits. In contrast, in
30 other subjects the blood pressure and heart rate rises that occurred
during the nurse's visit were 46.7% and 42.1% less (p less than 0.01) than
those occurring during the physician's visit. The late and less pronounced
pressor and tachycardic responses to the visit were also significantly less
(p less than 0.01) in the former than in the latter condition. These
results indicate that the error of overestimation of blood pressure
inherent in cuff blood pressure measurement by a physician cannot be
avoided by repeated visits by the physician over a short time span. It
clearly can be reduced, however, if blood pressure measurements are
performed by a nurse.
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Alerting reaction and rise in blood pressure during measurement by physician and nurse
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