Patient self-monitoring of blood pressure in general practice: the 'inverse white-coat' response.
Self-monitoring of blood pressure may give a truer estimate of usual blood pressure than readings by a doctor in the surgery, and may save time for health professionals. This study aimed to determine the accuracy of self-monitoring in the surgery using a wrist oscillometric sphygmomanometer (Omron RX). One hundred and seventy-three patients were taught to record their own blood pressure with the Omron RX. One hundred and nineteen patients recorded three self-measurements at monthly intervals, and their readings were compared with those of an experienced nurse using the Omron RX and a mercury sphygmomanometer. On average, patients' readings were higher than the nurse's readings (mean difference in phase 1 = systolic pressure 4.7 +/- 13.1 mmHg, diastolic pressure 2.7 +/- 9.3 mmHg [both P < 0.001]). Only half of the patients' readings were within 10 mmHg systolic and 5 mmHg diastolic of the nurse's readings. The readings by the nurse using both devices did not differ.
Turnbull
Sue M
SM
Manor Health Centre, Liscard Village, Liscard, Wallasey CH45 4JG.
Magennis
Sean P
SP
Turnbull
Chris J
CJ
D000368:Aged; D001795:Blood Pressure Determination / Q000592:standards; D004739:England; D005194:Family Practice / Q000295:instrumentation / Q000592:standards*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000592:standards; D012680:Sensitivity and Specificity; D019722:Sphygmomanometers / Q000592:standards