Noninvasive Ambulatory Blood Pressure Monitoring During Clinic Visit in Elderly Hypertensive Patients

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Abstract
The pressor response to blood pressure measurements in a routine outpatient clinic setting has not been adequately characterized. Blood pressure was monitored in 104 hypertensive patients, mean age of 62 years, by noninvasive automatic ambulatory monitoring device at 5 minutes interval throughout the time of their visits to our outpatient clinic. The average rise in systolic and diastolic blood pressures upon patients'' visit to doctor''s room was 17 and 7 mm Hg respectively. There was concomitant tachycardia (average rise 3 beats/minute). The rise in blood pressure and heart rate was significantly related to the value in the doctor''s room, but was not related to either age, the value in the waiting room or treatment. The rise in systolic blood pressure was more prominent in female patients than in males. Blood pressure and heart rate returned to the baseline level by approximately 40 minutes after leaving the doctor''s room. These results illustrate a transient rise in blood pressure during measurement by a doctor in an outpatient clinic. Noninvasive ambulatory blood pressure monitoring during clinic visit in hypertensive patients may be a potentially useful and convenient method for the better diagnosis of hypertension by abolishing the alerting reaction.