68th Scientific Sessions
November 13-16, 1995
Potential Overdiagnosis of Hypertension With Less Than Six Consecutive Blood Pressure Measurements
Mark Goodman, Alberto R. Yataco, Dina Darwish, The Union Memorial Hospital, Baltimore, MD
Two to three consecutive blood pressure measurements (BPM) have been
suggested to obtain a resting baseline blood pressure (BP). We studied
medical residents to evaluate the efficacy of multiple consecutive BPM
to overcome the startle/reactivity response and behaviorally “habituate”
the patient to a novel, aversive, constricting stimulus associated with
obtaining BPM. An automated oscillometric digital Dinamap monitor was
used to record systolic blood pressure (SBP) and diastolic blood pressure
(DBP), in 34 normotensive medical residents (18 males, 16 females, age
30.02±3.3) to avoid the “white-coat hypertension” phenomenon.
BP was recorded six times at 90 second intervals with the subjects seated,
back and arm supported with the BP cuff at the level of the heart. We
found that the change in mean SBP over the first three consecutive readings
was significantly different (p<=.01). There were no significant differences
noted again until the sixth and final reading of mean SBP. DBP revealed
no significant differences by MANOVA when comparing across the six observations.
This rapid methodology would potentially reduce overdiagnosis and treatment
of systolic hypertension.