Gil V, Martínez J L, López N, Marín P, Belda J, Merino J
Departamento de Medicina, Universidad de Alicante.
Rev Clin Esp. 1994 Mar;194(3):152-6.
The use of ambulatory monitorization of blood pressure has shown the importance of the alarm reaction or white coat reaction and its conditioning factors in some patients. The influence of place (medical facility or home) and person who performs the procedure (doctor or nurse) on the taking of blood pressure is studied with regard to degree of control and/or disease diagnosis. The design is descriptive with a cross-section analysis. The sample is made up of 100 people-50 with hypertension and 50 who came to the center for reasons unrelated to blood pressure and were selected at random. Of the results obtained, the findings below are noteworthy. The number of controlled hypertension cases is fewer in the medical consultation (18 percent) or with nursing staff (22 percent) than in the patients' homes, whether the procedure is performed by the doctor (54 percent) or by the nurse (58 percent) (p = 0.000004). In the group of individuals who sought consultation, the number of hypertension cases detected by random measurements is fewer in the medical consultation (66 percent) than by the nursing staff (48 percent) and lowers significantly at home (p = 0.000001), whether taken by the doctor (22 percent) or by the nurse (20 percent). It is confirmed that figures for blood pressure at home are lower than those registered in the consultation, be they taken by the doctor or the nurse. We believe that the elevation in blood pressure is not exclusively attributable to the doctor and suggest that place where the procedure is performed is more important than the person who performs the procedure.
动态血压监测的应用已显示出警报反应或白大衣反应及其在某些患者中的影响因素的重要性。关于控制程度和/或疾病诊断,研究了地点(医疗机构或家中)和执行测量的人员(医生或护士)对血压测量的影响。设计采用横断面分析的描述性研究。样本由100人组成,其中50人患有高血压,50人因与血压无关的原因前来该中心且为随机选取。在所得结果中,以下发现值得注意。在医疗咨询中(18%)或由护理人员测量时(22%),血压得到控制的高血压病例数低于患者在家中,无论测量由医生进行(54%)还是由护士进行(58%)(p = 0.000004)。在寻求咨询的个体组中,通过随机测量检测出的高血压病例数在医疗咨询中(66%)少于护理人员测量时(48%),且在家中显著降低(p = 0.000001),无论由医生测量(22%)还是由护士测量(20%)。已证实,无论由医生还是护士测量,家中的血压数值均低于在咨询时记录的数值。我们认为血压升高并非完全归因于医生,并表明测量地点比执行测量的人员更重要。