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Angela Maria Geraldo Pierin, Gisele Machado Peixoto Mano, Viviane Souza, Josiane Costa de Lima, Katia Ortega, Edna Caetano Ignes, Heloisa Holanda Salomao, Jose Luis Nishiura, Carlos Alexandre Segre, Decio Mion, P-43: Blood pressure measurement taken by patients or nurses avoids observer's influence, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 44A, https://doi.org/10.1016/S0895-7061(01)01521-7
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Abstract
Several studies have shown that blood pressure measurement is influenced by the observer. However, little is known about the values of office blood pressure measurements (OBPM) taken by patients. Therefore, this study aimed at: a) comparing OBP performed by doctors, nurses, and patients; b) and identifying the variables which interfere with OBPM. Five hundred and fifteen hypertensive patients were studied (53+/-11 years; 70% female; 59% not white; 15% showed blood pressure <140/90mmHg; 17% with mild hypertension, 13% moderate, 15% severe, and 40% isolated systolic hypertension; 68% were under placebo; whereas 32% were under anti-hypertensive treatment). OBP was measured, according to a randomized order, by a doctor, a nurse, or the patients by themselves. Three consecutive measurements were performed by using an automatic oscillometric device (DIXTAL DX 2710), with the patients in a sitting position after a 5-minute rest. The results showed that (mean+/-SD): 1) OBPM by the doctor (160+/-20/97+/-1 mm Hg) was significantly higher (p<0.05) than OBPM by the nurse (156+/-20/95+/-15 mm Hg) and the patient (156+/-21/96 15 mm Hg). Systolic OBPM by the nurse was similar (p=NS) to OBPM by the patient whereas diastolic blood pressure was significantly lower (p<0.05); 2) in patients with severe hypertension Systolic OBPM by the patient (192+/-13 mm Hg) was significantly higher (p<0.05) than OBPM by the doctor (188+/-9 mm Hg) and the nurse which showed to be similar to each other; 3) both systolic and diastolic blood pressure showed to be significantly lower (p<0.05) when measured by women than when measured by doctors regardless of their gender (154+/-20 / 95+/-14 vs. 160+/-19 / 96+/-14mmHg, 156+/-21 / 95+/-14 vs. 161+/-19 / 96+/-15mmHg, respectively) whereas in male patients, no difference was observed between the measurement taken by the patients and the doctor regardless of their gender (157+/-22/97+/-15 vs. 159+/-22/99+/-16 mm Hg, 162+/-23/102+/-17 vs. 162+/-22/101+/-15 mm Hg). These results show that measurements taken by the patients by themselves or by the nurse can avoid blood pressure increase caused by the doctor; and that being a woman or having higher blood pressure interfere with blood pressure measurement taken by the different observers.
