Fear of Doctors give high blood pressure readings

24Jul14

If you have recently visited your doctor and have been told by them that your blood pressure is high, you could have cardiovascular problems – or you may simply just be scared of doctors and prefer a nurse to take your readings.

A nurse takes blood pressure readings

Another study into blood pressure measurement has found that readings taken by a doctor are often higher than those recorded by nurses and even more so when the readings are taken in a more relaxed environment such as the home. The phenomenon has been previously suggested, and termed the “white coat effect”, but this is the first comprehensive analysis of all available data.

The report, published in the British Journal of General Practice, says the difference found by looking at past studies was significant enough that it could affect the treatment options offered to patients. “Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up,” advised Dr Christopher Clark, from the University of Exeter, “but not where clinical decisions on blood pressure treatment depend on the outcome.”

“The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects. Some patients may be erroneously asked to continue to monitor their own blood pressure at home, which can build anxiety. These inappropriate measures could all be avoided by the simple measure of someone other than a doctor taking the blood pressure recording.”

Media health doctor Mark Porter commented in the Times:

I guess that’s why it is known as white coat hypertension 😉 – not that doctors wear white coats any more.

Best option is to take your own readings with a blood pressure monitor at home, 2 – 3 times a day over a week and average out the readings. Sit quietly for a few minutes first and if your BP bounces around a lot, record the lower of two readings each time.

Anything under 135/ 80 – 85 is good for a home reading for anyone under the age of 80 (we use higher thresholds in the surgery and for some older people)

If all is well, put the BP machine away for at least 6 months. Watching your BP has a nasty habit of increasing it.

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