[kantim]

Featured news - Doctors raise blood pressure in patients - University of Exeter


Doctors routinely record blood pressure levels that are significantly higher than levels recorded by nurses, the first thorough analysis of scientific data has revealed.

A systematic review led by the University of Exeter Medical School, and supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has discovered that recordings taken by doctors are significantly higher (by 7/4mmHg) than when the same patients are tested by nurses.

Dr Christopher Clark, of the University of Exeter Medical School, said the findings, published in the British Journal of General Practice, should lead to changes in clinical practice. “Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, 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.”

“Researchers should also think carefully about how to account for this effect in studies that compare treatment by doctors and nurses. Some studies have concluded that nurses are better at treating hypertension, when in fact those findings could be down to this recording bias.”

 

[JT Reagan]

Nah. It is "white coat syndrome." My doctor has the nurse do a check, then does one himself. I suspect they use the average.

 

[VeeJay]

White coat syndrome, for sure. There's a big difference between my BP at the beginning of an appointment, and that taken at the end when I'm more relaxed.

 

[jenmhahn]

I suffer from this problem…every time I get my BP tested by a Dr. My dad does too. I could test at home every night and get a low reading and then go to the Dr and it will be high. I have actually been taking pictures of my BP machine at home when I test so that I can show my Dr.

 

[bignick]

Yea, the doc coming in wearing surgical gloves, scalpels sticking out of his shirt pocket and headlight on his forehead wanting to take my BP causes it to elevate.

 

[kantim]

One has to be careful with those doctor reading. I have a doctor friend that told me about a case he had with very high reading on his office he prescribed blood pressure medications. The patient went home filled the prescription just to end in the emergency room because he fainted from low blood pressure. He returned to the doctor office with very high blood pressure reading. Was prescribed another blood pressure medication just to end again at the hospital. My friend then realized that the patient just had white coat syndrome. So beware and always monitor your blood pressure at home to be sure the diagnosis is correct and the blood pressure prescription is working as it should.

 

[bignick]

I was attempting to be humorous (sarcastic) in post #5. I guess people thought I was serious. I was unaware of white coat syndrome.

I could see the shapely young nurse in the mini skirt causing my blood pressure to rise though, lol.

 

[jademuffin]

I could see the shapely young nurse in the mini skirt causing my blood pressure to rise though, lol.

"HellllllOOOOOO NURSE!"

I can just picture that scene. Probably because I have a number of friends who would do just that. And because cartoons are fun.

 

[silvertiger]

My blood pressure rises because that darn cuff hurts!!

 

[Shanny]

It really DOES! Back when the dr/rn would pump it up themselves, I never had any discomfort, but these automatic ones just keep pumping until it hurts all the way down to my fingertips!

 

[Daytona]

I went through hell and back because my doctor refused to accept that I have white coat syndrome. I took blood pressure medication which caused chronic headaches, fainting and heart palpitations. I worried myself sick trying to prove to the doctor that my blood pressure was fine at home. I was eventually referred to a cardiologist who did a very expensive (and invasive) test where they imaged my heart and declared that it looked perfect. The cardiologist then said to have any doctor who gave me grief give her a call.

It's one thing to say "oh it's just white coat" but it still gives me serious anxiety every time I go to the doctors office for any reason because I know they will measure my blood pressure and it won't be good. *throws hands up in the air*

 

[Patdart]

My internist told me in the beginning that I had what he called 'labile' BP and after a conversation he told me to never let anyone check me for 20 minutes after I sat down…I have a fuss when most like to show me into my room and immediately check BP. I've gotten where I have to insist and make them come back to test it. Drives me nuts. Some just don't and I figure if they don't know better and let it go. I do.

 

[Shanny]

OWC would have his patients lie down in the exam room if they posted a higher than usual reading. Then after resting 15-20 minutes, would retest them and often got a better reading. 'Course this is the same guy who caught holy hell from his partners for spending too much time with his patients & not billing enough charges.

 

[kyteflyer]

My doc always does it 2 or 3 times if its up. It almost always has subsided to its normal by then. My BP *is* high, but its mostly high in the evening, even with medications. I remain convinced, as I have from day 1 of BP meds, that ACE Inhibitors are not necessarily an absolute for diabetics... but out here, thats what they give us, regardless of what has worked in the past. My BP responds really well to beta blockers, and barely budges with ACE inhibitors. Guess whats prescribed.

 

[Shanny]

I started with the ACE inhibitor Lisinopril, but its signature 'cough' developed and my doc switched me to a beta blocker. Mebbe you wanna develop a cough, eh, Sue?

 

[JT Reagan]

I really do have high blood pressure and take meds for it. It just gets higher in the doctor's office. My pressure really goes up in cold and hot weather--the extremes like zero and over 95 degrees. I am lucky to have a doctor who knows me and discounts the high numbers in his office. He sends me to our county health department that does free bp screenings. Always works well there.

 

[Shanny]

Even when I see the ophthalmologist, they check my b/p . . . and it's always still a little high, especially systolic. I guess if diastolic stays low it must be okay - the heart is still resting between beats.

 

[kantim]

Recently they changed the guidelines for high blood pressure. But in diabetics doctors tend to over prescribe them anyway the same as statins for prevention. But the new guidelines are among adults age 60 and older with high blood pressure, aim for a target blood pressure under 150/90, among adults age 30 to 59 with high blood pressure, aim for a target blood pressure under 140/90 and among adults with diabetes or chronic kidney disease, aim for a target blood pressure under 140/90.

There is an Ayurvedic supplement from Divya Pharmacy mutka vati that claims to "cure" all types of causes for blood pressure is sold in Amazon and Ebay. I have read a lot of good reviews in a forum I used to read from a supplement supplier that didn't sell the product but the forum was eliminated by the company so the post are no longer available.

 

[walkerwally1]

I have been on meds for high BP for years and my doctor has tried to keep it under 140/90 which was about where it was for a long time. I don't know if it is due to lchf or more exercise, or probably both, but lately my BP has been mostly around 120/80, and often lower. However I was at the Dentist office about a month ago and when they took my BP it was 155/100. It did not surprise me at all, it was the Dentist . Talk about white coat syndrome.

 

[jenmhahn]

I had a glaucoma eye test done yesterday at my diabetic clinic. I am not going to lie, I was super nervous, I hate getting drops in my eyes. I thought for sure I would be high when they checked my BP. It was 116/75 when they checked! I was kind of shocked because I always am high when I get it checked at the Dr. I was very happy