The necessity of the patient sitting alone in silence for the measurement of blood pressure using a BpTRU device

Dorward, Douglas Morrison Tulloch (2019) The necessity of the patient sitting alone in silence for the measurement of blood pressure using a BpTRU device. Masters thesis, Memorial University of Newfoundland.

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Abstract

Context: While previous studies have demonstrated an increase in blood pressure when measured while talking, the effect of conversation on the measurement of blood pressure using a BpTRU device is unknown. Objective: In adults who have their blood pressure measured using a BpTRU device in the primary care setting, does the presence of a healthcare professional engaging the patient in conversation during the measurement period affect the recorded blood pressure compared to the patient being alone in a private room and silent during the measurement period? Design: An assessment of two approaches of measuring blood pressure using a BpTRU device in which participants serve as their own control and the order of testing is randomized. Participants: Adults (n=272) aged ≥ 19 years recruited from an academic family practice unit in St. John’s NL. Intervention: Participant’s blood pressure was measured twice using a BpTRU device, once while alone in a quiet room maintaining silence and once while engaging in a health-related conversation. Whether blood pressure was measured first during conversation or during silence was randomized. Outcome Measures: Systolic and diastolic blood pressure, and the mean difference in systolic and diastolic blood pressures between talking and silent measurement conditions. Results: Mean systolic blood pressure was 9 mmHg higher (95% CI 8.2 – 10.5) and mean diastolic blood pressure was 8 mmHg higher (95% CI 7.6 – 8.9) when measured during conversation compared to when measured in silence. Systolic and diastolic blood pressure measured during conversation remained significantly higher after controlling for all other variables in multiple linear regression analysis. Conclusion: To avoid inaccurate measurement of blood pressure which could result in the overdiagnosis and overtreatment of hypertension, blood pressure measurement with the BpTRU device should be conducted with patients alone and in silence.

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