Researchers who studied an effect by measuring nerve activity said that a doctor being present during a blood pressure triggers a fight or flight response that may affect the result.
The phenomenon that occurs when there is a rise in blood pressure in some people who are measured by a medical professional is known as white coat hypertension. This has been known to man for decades. It happens in 1/3rd of people who have high blood pressure.
Italian researchers in a small study that was published in the American Heart Association journal, examined the effect’s origins by gauging blood pressure, heart rate, and nerve traffic in the presence and absence of a doctor.
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The scientists revealed that they found a huge reduction in the body’s alarm response when a doctor was absent.
Dr. Meena Madhur, an associate professor of medicine at Vanderbilt University in Nashville, Tennessee said that an increase in blood pressure and heart rate is what happens when the body perceives a threat.
Madhur said that if you are out in the wild and a bear was trying to get you, you would require your blood vessels in your skin to constrict and the blood vessels in your muscles to dilate in order to facilitate more blood flow to those organs so that you can run faster than you normally would.
18 people were included in the study, out of which 14 were men who had mild to moderate high blood pressure which did not require treatment. Each individual was examined in a lab where an electrode measures nerve activity in the skin and muscles.
Readings were taken both when a doctor was present and when a doctor wasn’t present.
In the presence of a doctor, both blood pressure and heart rate shot up, and nerve traffic that was close to the skin and skeletal muscle suggested a typical fight or flight reaction.
In contrast, when the readings were taken in the absence of a doctor, cardiovascular and neural responses were very varied and the typical signals of a fight or flight response were not there whatsoever.
This study was the first to document changes in the sympathetic nervous system which regulated the flight or fight response. The first number in a reading, a measure of the pressure against the artery walls when the heartbeats are known as peak systolic blood pressure. This was, on average, around 14 points lower in the absence of a doctor. The peak heart rate was also lowered by almost 11 beats per minute when alone.
. The researchers wrote that this was with regards to whether a doctor was overseeing a blood pressure measurement or not.
Grassi said that it was highlighted by the findings that blood pressure measurements are very complex and are very often affected by the involuntary reactions of the nervous system.
He added that measurements without the presence of a doctor may reflect true blood pressure value better than in the presence of a doctor.
Madhur said that even though the concept of white coat hypertension is not novel, this study highlights the importance of being more conscious of the method in which blood pressure is measured in the clinic.
The American Medical Association and American Heart Association released a report in the previous year that encouraged measurement of blood pressure at home instead of at the clinic.
The researchers said that the complexity of the testing kept the scale of the study relatively small and that follow up research would be required to reveal more information.