Why the study?
Does talking, reading, or silence affect clinical blood pressure measurements and the 'white coat' phenomenon in essential hypertensive patients?
Does talking, reading, or silence affect clinical blood pressure measurements and the 'white coat' phenomenon in essential hypertensive patients?
Measuring clinical blood pressure during a period of silence or reading rather than talking improves predictive value by minimizing the 'white coat' phenomenon.
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Recommend silence or reading during office BP measurement to minimize white coat effect; confirms talking as a key modifiable confounder.
To explore the mechanisms of the "white coat" phenomenon, the effects of talking, reading, and silence were analyzed. Fifty essential hypertensive patients were randomly allocated to periods of stress talking and relaxing reading, alternating with three periods of silence. While talking, systolic/diastolic blood pressure increased sharply, from 142 +/- 0.7/97.7 +/- 0.5 mm Hg to 159 +/- 0.7/111 +/- 0.5 mm Hg (P < .0001). While reading, systolic/diastolic blood pressure decreased (P < .0001). Moreover, talking and reading had opposite residual effects. The silence and reading periods gave the best approximations of the daytime ambulatory period. The predictive value of clinical blood pressure can be improved if measured during a period without talking, thus decreasing the "white coat" phenomenon.
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C. Le Pailleur (1998) studied this question.
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