The effect of physician presence on blood pressure

To evaluate the effect of physician presence on blood pressure (BP) and the influencing factors.

This study included 600 adult outpatients, of whom 335 had hypertension and 265 did not have hypertension. An automated BP measurement device was used for all measurements of BP. After a 10-min rest, the first two readings were measured (BP1) in the presence of a physician, and then five BP readings were taken when the patient was left alone in the room and their average as automated office blood pressure (AOBP); finally, the second office BP (BP2) was measured (BP1) when the physician was present again. The differences in BP1 and BP2 with AOBP were calculated as ΔBP1 and ΔBP2.

(a) Both BP1 and BP2 were significantly higher than AOBP (131±1/79±1 and 127±1/76±1 vs. 125±1/74±1 mmHg, both P<0.05). The hypertension detection rates on BP1 and on BP2 were 38.5 and 32.4%, but only 23.8% on AOBP (both P<0.05). (b) The ΔSBP1 was significantly higher than ΔSBP2 (6.8±9.3 vs. 2.0±7.7 mmHg, P<0.001), and ΔDBP1 was higher than ΔDBP2 (5.9±8.6 vs. 3.2±7.0 mmHg, P<0.001). (c) ΔSBP1, ΔSBP2, and ΔDBP were higher in the hypertension (EH) subgroup than in the nonhypertension (no-EH) subgroup. Meanwhile, in the no-EH group, the ΔSBP1 of the female subgroup were also significantly higher than that of the male subgroup.

The presence of a physician, even the second time, is associated with an increase in BP. Hypertensive patients and females have higher BP reaction for physician presence.