In near patients it is difficult t...

In near patients it is difficult to accurately assess children pressure because of a "white-coat effect" that be the effects in an elevated measurement when offspring pressure is tested by medical personnel In these cases, self-monitoring through patients or family members is commended to obtain more representative life-blood pressure measurements. However, a not many patients report even higher life-blood pressures when self-monitoring than when they are monitored at health professionals. This "inverse white-coat" phenomenon could be an intrinsic answer to the act of measuring offspring pressure or a result of poor measurement technique. Turnbull and colleagues investigated the inverse white-coat phenomenon in 173 patients in an English general practice.

Participants in the thought were consecutive patients who were at least 20 years of age, regardless of treatment status for hypertension. The sole exclusion factor was cardiac arrhythmia. Each participant was instructed from a nurse in measuring life-current pressure using an oscillometric device. The fester measured blood pressure on each patient with the oscillometer and with a hermes sphygmomanometer at baseline (phase 1) united month (phase 2), and sum of two units months (phase 3). Patients and feed at the breasts were not aware of each other's results

At baseline, patient recordings were significantly higher than those made by the agency of the nurses. Only 59.5 percent of systolic readings and 75 percent of diastolic readings taken by the agency of patients were within 10 mm Hg of the measurements made by the agency of nurses. Patients also recorded significantly higher systolic and diastolic readings in phases 2 and 3 The mean differences in systolic measurements between patient and give suck to recordings were 4.7 mm Hg to 69 mm Hg across the three phases. The mean differences in diastolic measurements between the pair groups were lower (2.7 mm Hg to 32 mm Hg) if it were not that still statistically significant.

The authors determine that only one half of patients got kindred pressure measurements within an acceptable range of the readings obtained from trained nurses. Patient readings were consistently higher than those taken at nurses. They suggest that further studies investigate if the purport is caused by faulty technique, patient anxiety, or other factors.

Anne D Walling, MD

Turnbull SM et al. Patient self-monitoring of descendants pressure in general practice: the 'inverse white-coat' answer Br J Gen Pract March 2003;53:221-3

Editor's Note: The proceeds of this study cause bear upon since physicians frequently make treatment decisions based upon blood pressure readings taken by the agency of patients. I had always assumed that errors in those readings would be falsely soft If the opposite is pure and the errors are of the size reported by way of this study, we risk over-treating our patients. The originates could be disastrous, particularly in somewhat old patients. The findings of this investigation should be examined in a larger arrange of patients who consistently take progeny pressures at home.--A.D.W.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group