title: Are BP readings taken after a patient-physician encounter in a real-world clinic scenario the lowest of all the readings in a clinic visit.
abstract: OBJECTIVE
  To determine the difference in Blood Pressure (BP) readings taken before, during and after the clinic encounter.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Cardiology Clinic, The Aga Khan University Hospital, Karachi, from January to August 2013.
  
  
  METHODS
  Hypertensive and normotensive participants aged ³ 18 years were recruited. Pre-clinic BP was measured by a nurse and in-clinic BP by a physician. After 15 minutes, two post-clinic BP readings were taken at 1 minute interval. All readings were taken using Omron HEM7221-E.
  
  
  RESULTS
  Out of 180 participants, males were 57% and 130 (71%) were hypertensive. Mean SBP (Systolic BP) taken preclinic, in-clinic, post-clinic 1 and post-clinic 2 were: 126 ± 20 mmHg, 131 ± 23 mmHg, 126 ± 20 mmHg and 121 ± 21 mmHg respectively (p < 0.001). Mean DBP (Diastolic BP) taken pre-clinic, in-clinic, post-clinic 1 and post-clinic 2 were 77 ± 12 mmHg, 81 ± 13 mmHg, 79 ± 12 mmHg and 79 ± 11 mmHg respectively (p < 0.001).
  
  
  CONCLUSIONS
  BP taken in the post-clinic setting may significantly be the lowest reading in a clinic encounter, making in-clinic BP unreliable to diagnose or manage hypertension.
authors.affiliation: Resident, Department of Medicine, The Aga Khan University, Karachi.
authors.forename: Hunaina
authors.initials: H
authors.lastname: Shahab
authors.affiliation: Intern, Ziauddin University, Karachi.
authors.forename: Hamza Sohail
authors.initials: HS
authors.lastname: Khan
authors.affiliation: Department of Medicine, The Aga Khan University, Karachi.
authors.forename: Aysha
authors.initials: A
authors.lastname: Almas
authors.affiliation: Department of Cardiology, Tabba Heart Institute, Karachi.
authors.forename: Sohail Abrar
authors.initials: SA
authors.lastname: Khan
authors.affiliation: Department of Cardiology, The Aga Khan University, Karachi.
authors.forename: Aamir Hameed
authors.initials: AH
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010817:Physician-Patient Relations; D010820:Physicians