'White Coat Effect' Higher for Doctors than Nurses

Mean blood pressures lower for nurses compared to readings made by doctors at same visit.
Mean blood pressures lower for nurses compared to readings made by doctors at same visit.

Doctors' readings of blood pressure are often higher than measurements made by nurses at the same visit, according to research published in the British Journal of General Practice.

Christopher E. Clark, PhD, from the University of Exeter in the United Kingdom, and colleagues conducted a systematic literature review to identify studies of adults reporting mean blood pressures measured by doctors and nurses at the same visit.

The researchers found that, based on 15 studies (11 hypertensive; four mixed hypertensive and normotensive populations), nurse-measured blood pressures were lower compared with doctors' measurements (weighted mean differences: systolic −7.0 mm Hg, diastolic −3.8 mm Hg). Differences were lower in studies at low risk of bias (systolic −4.6 mm Hg; diastolic −1.7 mm Hg). Doctors' readings were 60% more likely to be used than nurses' readings to diagnose white coat hypertension.

This systematic difference has implications for hypertension diagnosis and management," the authors wrote.

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