Læknablaðið - 15.12.1996, Page 21

LÆKNABLAÐIÐ 1996; 82
845
Áhrif umhverfis á niðurstöður við
kembileit á of háum blóðþrýstingi
Gísli Baldursson1,21, Gunnar H. Gíslason1'2), Helga I. Sturlaugsdóttir2*, Þorkell Guðbrandsson3’
Baldursson G, Gíslason GH, Sturlaugsdóttir HI,
Guöbrandsson Þ
The effects of different settings on outcome when
screening for high blood pressure
Læknablaðið 1996; 82: 845-50
Introduction: It has become increasingly popular to
offer blood pressure measurements under circum-
stances that differ from the usual setting, for exam-
ple measurements in supermarkets, pharmacies, at
exhibitions etc. It is well known that environmental
factors as well as doctor and patient relationship can
affect blood pressure measurement. This must be
considered in the diagnosis and treatment of hyper-
tension. The aim of this study was to evaluate some
of these phenomena.
Material and methods: Subjects attending local su-
permarket in a rural community were offered blood
pressure measurement two Friday afternoons. All
measurements were done in a sitting position with a
fully automatic blood pressure recorder, AND
UA-767. Hypertension was diagnosed if blood pres-
sure exceeded 140 mm Hg systolic and/or 90 mmHg
diastolic (according to WHO standards). Those who
had hypertension were followed by two office and
six home measurements. For the statistical analysis,
a t-test for paired data was used. Results are report-
ed as means.
Results: Total of 125 subjects had their blood pres-
sure measured. By the WHO criteria 64 (51.2%) of
the subjects had hypertension. Mean blood pressure
was significantly higher in the supermarket com-
pared to office both for systolic, 17.1 (C.1:12.8-21.4)
Frá '’Heilsugæslustöðinni Egilsstöðum, 2)Sjúkrahúsinu Eg-
ilsstöðum, 3)Heilsustofnun NLFÍ Hveragerði. Fyrirspurnir,
bréfaskipti: Gísli Baldursson, Heilsugæslustöðinni, 700
Egilsstaðir. Sími 471 1400, bréfsími 471 1971.
Lykilorð: Blóðþrýstingur, mælistaðir, kembileit, hvítsloppa-
áhrif, heimamælingar.
mmHg, and diastolic, 5.2 (C.1:2.7-7.7) mmHg,
blood pressure. Eighty per cent of the subjects had
normal blood pressure at home. Compared to su-
permarket the mean blood pressure reduction was
29.3 (C.1:24.7-33.9) mmHg for systolic and 10.1
(C.1:7.2-13.0) mmHg for diastolic. A “white coat
effect” (office vs. home BP) was present. Mean
blood pressure reduction 12.9 mmHg (C.1:10.1-15.7)
mmHg for systolic and 5.0 mmHg (C.1:3.4-6.6) for
diastolic.
Conclusions: This unconventional approach to
blood pressure screening seems to be both cheap
and acceptable for the public. Blood pressure meas-
urements under these circumstances on the other
hand are not directly comparable to the standard
values given by WHO and should be looked on as
reflecting the blood pressure each given time. Envi-
ronmental factors therefore influence the blood
pressure measurement greatly. The interaction be-
tween the physician and the patient seems to be a
major factor in the office vs. home blood pressure
difference, the so called white coat effect. On the
other hand there must be another explanation for
the difference between blood pressure measure-
ment in supermarket and at home. Different cir-
cumstances and their effect on reference values
when offering blood pressure measurements must
be taken into consideration. This should be kept in
mind when diagnosing hypertension.
Ágrip
Inngangur: Að undanförnu hefur færst í
vöxt að bjóða upp á blóðþrýstingsmælingar við
aðrar aðstæður en venjulega hefur tíðkast, svo
sem á sýningum, í apótekum og stórverslun-
um. Tilgangur þessarar rannsóknar var að
kanna mun á blóðþrýstingsmælingum við mis-
munandi aðstæður.
Efniviður og aðferðir: Farið var í kjörbúð
tvö föstudagssíðdegi milli kl. 17 og 19 þar sem
þeim sem vildu var boðið upp á blóðþrýstings-
mælingu. Notaður var sjálfvirkur blóðþrýst-
ingsmælir, AND UA-767. Háþrýstingur var