If your doctor tells you your blood pressure is high you could be at risk of cardiac problems and need blood pressure treatments. Alternatively you could just be scared of doctors.
A recent study has suggested that the blood pressure readings taken by doctors are routinely higher than those taken by nurses. This phenomenon is not new, and ‘white coat’ syndrome has been much talked about in the past, however this study is the first to offer definitive analysis of the available data.
The report was published recently in the British Journal of General Practice. They concluded that the differences they found in past studies could be used to alter the way patients receive blood pressure treatments in the future. According to Dr. Christopher Clark of Exeter University UK, who led the research, while doctors should continue to take readings during assessments of ill patients, or as part of routine check-ups, it might be advisable that they don’t where clinical decisions on blood pressure treatment depend on the outcome.
The difference noted was enough to tip patients over the threshold for receiving treatment for hypertension. It could lead to them being prescribed unnecessary medication that might have unwanted side-effects for no reason. Or, patients might be asked to keep a close eye on their blood pressure at home, which could increase their anxiety and even increase their risk of developing hypertension.
Earlier research identified ‘white coat syndrome’ as a problem
This new research follows on from earlier studies that found patients believed to have hard-to-treat high blood pressure may actually have been suffering from doctor-induced nerves. The research, carried out by the University of Barcelona pointed out that up to a third of patients who appear to be unresponsive to blood pressure meds may simply be showing signs of ‘white coat syndrome’. Up to 70,000 patients with diagnosed hypertension were studied as they went about their daily lives. In total 37% of patients formerly thought to be resistant to blood pressure treatments turned out to have the syndrome. Their blood pressure rose when they visited the doctor giving the wrong impression that their treatment was unsuccessful.
Subjects had to wear a portable monitor which took readings every 20 minutes day and night, a procedure known as ‘ambulatory’ monitoring. Patients with ‘real’ hypertension showed high readings at work, during the day and during the night. Those with resistant hypertension included high number of smokers, diabetics and people with heart conditions. Visiting the doctor seemed to falsely identify high blood pressure in many people thought to be resistant to drugs.
By simply having someone other than a doctor take the blood pressure readings more accurate blood pressure recording could be achieved. And by using ambulatory monitoring a more accurate picture of a patient’s blood pressure could be achieved. Using at home devices to help monitor high blood pressure could be helpful for some. The National Institute for Health and Clinical Excellence (NICE) recommends that people with high blood pressure readings take a third reading at home to rule out ‘white coat’ syndrome. This is especially true considering the amount of people who have high blood pressure without knowing it.
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