Key result
First blood pressure measurements were 6.7 mmHg and 2.4 mmHg higher than second measurements for systolic and diastolic BP respectively, demonstrating a white coat effect.
Why the study?
Does the first blood pressure measurement differ significantly from a second measurement taken shortly after due to the white coat effect in adults undergoing medical checkups?
Observational (n=17,775)
Does the first blood pressure measurement differ significantly from a second measurement taken shortly after due to the white coat effect in adults undergoing medical checkups?
Blood pressure measurements fluctuate significantly even within a short interval, with the first measurement being systematically higher than the second, highlighting the need for careful measurement practices to avoid overdiagnosis of hypertension.
Answers are grounded in this paper and cite their sources.
Repeated BP readings may mitigate white coat overestimation in checkups; leaves open optimal protocols for routine practice and trials.
In this paper, we evaluate the difference between the first and second measurements of blood pressure (BP) when BP is measured twice using the results of 17,775 medical checkups. The two measurements for both systolic BP (SBP) and the diastolic BP (DBP) fluctuated a large amount even though they were measured at a short interval. The first measurements were 6.7 and 2.4 mmHg higher than the second ones for SBP and DBP, suggesting a white coat effect. Then, the factors that might affect the differences between the two measurements were analyzed by the regression models. For both SBP and DBP, the difference increased as the first measurement increased. Age, gender, BMI and alcohol consumption were other important factors affecting the difference. In the case of a typical male individual, the typical criteria for hypertension of 140/90, 160/100 and 180/110 mmHg criteria in the first measurement would correspond to 135/86, 150/94 and 165/102 mmHg in the second measurement. The necessity of developing accurate and cost-efficient BP measurement methods is strongly suggested.
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Nawata et al. (2017) conducted an observational in Blood pressure (n=17,775). First blood pressure measurement vs. Second blood pressure measurement was evaluated on Difference between first and second blood pressure measurements (MD 6.7 mmHg for SBP, 2.4 mmHg for DBP). First blood pressure measurements were 6.7 mmHg and 2.4 mmHg higher than second measurements for systolic and diastolic BP respectively, demonstrating a white coat effect.
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