Fear of doctor visit elevates blood pressure for some
Recent studies and presentations at medical meetings point to a growing realization among doctors that as many as a third of all Americans taking medications for high blood pressure either shouldn't be on them or are taking doses that are too high or too low. The new findings about inaccurate blood-pressure readings relate to both a previously observed phenomenon, known as white-coat hypertension, and a new observation regarding the body's natural internal clock. '' 'White-coat hypertension' refers to the phenomenon in which a person's blood pressure is elevated simply due to the fear or anxiety of having it measured in a doctor's office,'' Dr. Jan A. Staessen of the Katholieke Universiteit in Leuven, Belgium, explained at the recent meeting of the European Society of Hypertension in Milan, Italy.
What doctors have recently discovered is that as much as 25% of people suffer from white-coat hypertension, Staessen said. In essence, the only time a person with white-coat hypertension has a high blood-pressure reading is in a doctor's office. What's more, as many as 10% of all people classified as having high blood pressure do not experience the normal changes in pressure that occur throughout the day. Typically, blood pressure peaks in the early morning, descends slowly throughout the day, and then bottoms out in the middle of the night.
''It is conceivable that people who do not experience this normal fluctuation in blood pressure will have their readings taken in a doctor's office at the time of day when their pressure is highest,'' said Dr. Michael Weber, editor of the American Journal of Hypertension. These observations were put to the test in a recent study by Staessen of 419 people who were taking medications to control their blood pressure. Half the patients visited their doctors for weekly blood-pressure tests, and the other half used home blood-pressure monitors. By the end of the six-month study, 26% of patients using home monitors had been told to discontinue their medications because their readings were normal. Only 7% of those visiting their doctors for measurements were taken off drugs.
Another study released at the Milan hypertension
meeting found that readings were 25% lower in a group of 46 people with
high blood pressure who took their blood pressure at home, as compared
with a group of 50 people who continued on with their doctors. Staessen's
study, reported in the current issue of the Journal of the American Medical
Association, concluded that 25% to 35% of all patients on high blood- pressure
medications may be taking them unnecessarily or in inaccurate doses.
(Investors Business Daily, Oct. 13, 1997)
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