Talking with a doctor during a visit elicits increases in systolic and diastolic blood pressure

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Abstract

Objective

To investigate the impact of talking with doctors on blood pressure (BP) in outpatients.

Patients and methods

This study included 122 hypertensive and 78 normotensive outpatients. BP was measured initially in silence with oscillometric BP monitors three times at 1-min intervals as follows: pre-1, pre-2, and pre-3. BP was then measured with the same device immediately, at 3 min, and at 5 min after talking commenced as follows: during-1, during-3, and during-5. When talking stopped, BP was measured again as post-1, post-3, and post-5. The increments in BP and heart rate (HR) were the differences during and pre-3 values.

Results

Systolic blood pressure/diastolic blood pressure (SBP/DBP) increased significantly at 1 min during talking compared with pre-3 values. The maximum increment of SBP was 9.1 mmHg, occurring at 3 min and continuing up to 5 min during the talking stage. The maximum increment of DBP was 4.5 mmHg and that of HR was 2.7 bpm, both occurring at 1 min. When talking stopped, the SBP and DBP significantly decreased immediately. SBP at 5 min, DBP at 3 min, and HR at 1 min were similar to their pre-3 values. Logistic multifactor analysis showed that pre-SBP3 level (R=0.141, P=0.023) was an independent factor, but anxiety scale, age, sex, BMI, and hypertension history were not independent factors.

Conclusion

The maximum SBP increment is 9.1 mmHg and DBP increment is 4.5 mmHg during 5 min of talking with doctor. Meanwhile, the increased SBP needs about 5 min to return to the baseline level.

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