Effect of environment of blood pressure: Home versus hospital

Abstract

The effect of environment of blood pressure was studied by recording intra-arterial pressure continuously in nine patients with essential hypertension during controlled periods of activity and rest at home and in hospital. Mean systolic pressure was higher at home (152 ± 16 mm Hg) than in hospital (138 ± 11 mm Hg, p < 0.01), the difference being greatest during the period of activity (165 ± 21 vs 142 ± 13 mm Hg, p < 0.001); heart rates and diastolic pressures did not differ significantly at these times. Systolic pressure recorded by conventional sphygmomanometry was also higher at home (173 ± 23 v 159 ± 23 mm Hg, p < 0.01), as was diastolic pressure (98 ± 10 v 89 ± 11 mm Hg, p < 0.02). Systolic pressure was consistently higher at home, and this effect was independent of the presence of an observer. This must be taken into consideration when assessing blood pressure and efficacy of treatment in hospital.