Lippincott, Williams & Wilkins, Journal of Hypertension, 6(31), p. 1131-1135, 2013
DOI: 10.1097/hjh.0b013e3283605c71
Full text: Unavailable
OBJECTIVE: Previous studies have shown that blood pressure assessment by a nurse markedly attenuates the pressor and tachicardic responses triggered by the physician blood pressure measurement. Whether and to what extent this attenuation reflects a different pattern of the neuroadrenergic responses to doctor or nurse blood pressure evaluation is unknown. METHODS: In 19 lean untreated mild essential hypertensive patients (age 39.1 ± 2.4 years, mean ± SEM), we measured beat-to-beat mean arterial pressure (Finapres), heart rate (ECG), and efferent postganglionic muscle and skin sympathetic nerve traffic [muscle sympathetic nerve activity (MSNA) and skin sympathetic nerve activity (SSNA), respectively, by microneurography], before, during, and following a 10-min sphygmomanometric BP measurement by a doctor or by a nurse unfamiliar to the patients. Measurements were repeated at a 30-min interval to obtain, in separate periods, muscle and skin sympathetic nerve traffic recordings. Both the sequences (doctor vs. nurse and muscle vs. skin sympathetic nerve traffic) were randomized. RESULTS: A doctor visit induced sudden, marked, and prolonged blood pressure and heart rate increases, accompanied by a muscle sympathetic nerve traffic inhibition (average response: -18.1 ± 4.3%, P