The Blood Pressure Response Of Out-patients During Talking With Doctors

Objective: To investigate the blood pressure(BP)response of out-patients during talking with doctors.Methods: During May to September in 2016,200 out-patients(males 101,females 99;mean age 58.1±13.4 years old;mean SAS score 32.7±5.6)were included from the Second Affiliated Hospital of Nanchang University.Of them,122 were hypertensives(males 60,females 62;mean age 59.6±12.4 years old)and 78 were normotensives(males 41 and females 37;mean age 55.9±14.7 years old).At first,after a 10-min rest,blood pressure(BP)was measured in silence with oscillometric blood pressure monitors for 3 times with 1-min interval as Pre-1,Pre-2 and Pre-3.Then BP was measured with the same device at one,three and five minutes after talking as During-1,During-3 and During-5.When talking stopped,BP was measured again as Post-1,Post-3 and Post-5.The difference between During-BP and Pre-BP was considered as the talking-induced BP increment.Results: As compared with the Pre-3 values,talking induced acute significant increase of systolic blood pressure(SBP)from 123.5±19.0 mm Hg to 130.5±22.2 mm Hg(During-1)(P<0.01)with a mean increment of 7.0±9.3 mm Hg.similarly,an increase of diastolic blood pressure(DBP)from 71.1±12.5 mm Hg to 75.6±13.2 mm Hg(During-1)(P<0.01)with an increment of 4.5±5.7 mm Hg.The SBP continuously increased to 132.6±22.3 mm Hg,but DBP did not continuously increase during that period.Stop talking immediately induced a decrease of SBP from 132.6±22.3(During-5)to 126.2±20.5 mm Hg(Post-1)with an increment of 6.3±7.9 mm Hg and DBP from 75.4±13.3(During-5)mm Hg to 72.7±12.4(Post-1)mm Hg with an increment of 2.7±5.4mm Hg,respectively.During the Post-talking period,SBP and DBP continuously decreased and near to the Pre-3 values.the Post-1SBP and Post-3SBP were still higher than the Pre-3SBP,Post-5SBP near to the Pre-3 values(123.7 ±19.4 vs 123.5 ± 18.9 mm Hg,NS);Post-1DBP higher than the Pre-3DBP,Post-3DBP near to the Pre-3 values(71.6±11.7 vs 71.1±12.1mm Hg,NS).These results indicate that the increased SBP induced by talking needs about 5 min to recover to the baseline levels,DBP needs about 3 min to recover to the baseline levels.Similarly,talking immediately induced significant heart rate(HR)increase by 2.8±4.3 bpm,but the HR gradually decreased during the 5 min talking Period.All results are reported as mean ± SD(standard deviation).We used the SPSS 21.0 statistical package.The t test was performed for comparison of continuous variables and the paired t-test for comparison of paired data.Statistical significance was defined as P<0.05.Logistic multifactor analysis showed that Pre-3SBP level(P=0.023)was independent positive factor for the talking-induced SBP increment.Conclusion: The maximum SBP increment is 9.1 mm Hg and DBP increment is 4.5 mm Hg during 5 min talking with doctor.the increased SBP needs 5 min to return to baseline levels,DBP needs 3 min to recover to the baseline levels.it is better that BP should be measured before or 5 minutes after the doctor inquiry.