[Variability of arterial pressure during consultation. Effect of the physician and patient characteristics]

The decision to treat patients with high blood pressure depends largely on the level of pressure. However, a major difficulty is the great variability of blood pressure level in any individual patient. From May 1st 84 to July 1st 84, 259 patients were referred for the first time to the outpatient clinic and were seen by one of the four physicians. Before the consultation and during the medical interrogatory 18 + 8 measures were performed every 2 minutes by an automatic device using the oscillometric method. The physician measured the blood pressure (BP) using the auscultatory method according to the WHO recommendations, after the medical interrogatory. Measured by the physician, BP was 174 + 28/104 + 15 mmHg. Measured by the automatic device, BP was 158 + 22/94 + 14 mmHg. The correlation between the two methods was excellent (SBP: r = 0.88 and DBP: r = 0.82; p less than 0.001) but the mean of BPs automatically recorded was significantly lower (-15/11 mmHg) than the BP measured by the physician. The mean of the highest BPs recorded by the oscillometric method (179 + 26/108 + 16) was slightly higher than the BP recorded by the physicians. Blood pressure variability was defined by the standard error (SE) of BPs measured by the automatic device (SE: 11 + 4/7 + 2). SE was positively correlated with the BP level measured by the physician or by the machine and with the heart rate variability for both SBP and DBP, and with patient's age for SBP only. SE was negatively correlated with the coffee consumption and the tobacco consumption. Blood pressure variability was significantly higher in men than in women (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)