Objectives: To evaluate the effect of physician presence on blood pressure (BP) and the influencing factors.
Methods: This study included 600 adult outpatients, of whom 335 had hypertension and 265 did not have hypertension. An automated BP measurement device was used for all measurements of BP. After a 10-min rest, the first two readings were measured (BP1) in the presence of a physician, and then five BP readings were taken when the patient was left alone in the room and their average as automated office blood pressure (AOBP); finally, the second office BP (BP2) was measured (BP1) when the physician was present again. The differences in BP1 and BP2 with AOBP were calculated as ΔBP1 and ΔBP2.
Results: (a) Both BP1 and BP2 were significantly higher than AOBP (131±1/79±1 and 127±1/76±1 vs. 125±1/74±1 mmHg, both P<0.05). The hypertension detection rates on BP1 and on BP2 were 38.5 and 32.4%, but only 23.8% on AOBP (both P<0.05). (b) The ΔSBP1 was significantly higher than ΔSBP2 (6.8±9.3 vs. 2.0±7.7 mmHg, P<0.001), and ΔDBP1 was higher than ΔDBP2 (5.9±8.6 vs. 3.2±7.0 mmHg, P<0.001). (c) ΔSBP1, ΔSBP2, and ΔDBP were higher in the hypertension (EH) subgroup than in the nonhypertension (no-EH) subgroup. Meanwhile, in the no-EH group, the ΔSBP1 of the female subgroup were also significantly higher than that of the male subgroup.
Conclusion: The presence of a physician, even the second time, is associated with an increase in BP. Hypertensive patients and females have higher BP reaction for physician presence.