title: Talking effect and white coat phenomenon in hypertensive patients.
abstract: Both white coat effect (the tendency of blood pressure to rise during a medical visit) and talking effect were analyzed in 42 patients with essential hypertension. Blood pressure was measured during the clinic visit and over the subsequent 24-hour ambulatory period, with the physician performing 49 +/- 4 measurements for each patient. Three silent periods and two talking periods (stress and relaxation) were randomly allocated in a crossover design and studied, using analysis of variance. During the initial 11-minute silent period, systolic/diastolic blood pressures increased by 6 mm Hg/5 mm Hg. During the subsequent talking periods, these variations were significantly greater: +22 mm Hg/+17 mm Hg. Measures of systolic/diastolic blood pressure were higher during stressful talking than during relaxed talking. The talking and its emotional contents seemed to explain 70% of the white coat phenomenon. To minimize the white coat phenomenon in the clinic, physicians, nurses, and clinicians are advised to measure blood pressure during an initial period of silence.
authors.affiliation: Clinique Cardiologique, Hôpital Necker, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Le Pailleur
authors.forename: A
authors.initials: A
authors.lastname: Vacheron
authors.forename: P
authors.initials: P
authors.lastname: Landais
authors.forename: C
authors.initials: C
authors.lastname: Mounier-Véhier
authors.forename: J M
authors.initials: JM
authors.lastname: Feder
authors.forename: P
authors.initials: P
authors.lastname: Montgermont
authors.forename: J P
authors.initials: JP
authors.lastname: Jais
authors.forename: J P
authors.initials: JP
authors.lastname: Metzger
mesh_terms: D003142:Communication; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D014796:Visual Perception