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Blood Pressure Measurement
Published in John G. Webster, Halit Eren, Measurement, Instrumentation, and Sensors Handbook, 2017
Shyam Rithalia, Mark Sun, Roger Jones
From the growing number of publications on the topic in recent years, it is evident that the interest in self-measurement of blood pressure has increased dramatically. There is also evidence that the management of patients with high blood pressure can be improved if clinic measurements are supplemented by home or ambulatory monitoring. Research has shown that blood pressure readings taken in the clinic can be elevated, by as much as 75 mmHg in SP and 40 mmHg in DP, when taken by a physician. The tendency for blood pressure to increase in certain individuals in the presence of a physician due to stress response is generally known as “white-coat” hypertension [12]. When reasonably priced and easy to use, oscillometric devices became commonly available in the early 1970s, public interest in the self-measurement of blood pressure increased, and this has made it possible for greater patient involvement in the detection and management of hypertension [13]. Health-care costs may also be reduced by home monitoring. Indeed, a recent study found that costs were almost 30% lower for patients who measured their own blood pressure than those who did not [14]. Measurements taken at patient’s home are more highly correlated to 24 h blood pressure levels than clinic readings are. It has also been shown that most patients are able to monitor their blood pressure and may be more relaxed as well as assured by doing so, particularly when experiencing symptoms [15].
Diagnostic Devices
Published in Laurence J. Street, Introduction to Biomedical Engineering Technology, 2016
As a final note, some patients may suffer from “white coat hypertension,” in that they become nervous or agitated when a doctor or nurse approaches, or when undergoing any medical test. The reaction can cause an increase in blood pressure, which is usually temporary. Repeated measurements after the patient relaxes will give more realistic readings.
Diagnostic Devices
Published in Laurence J. Street, Introduction to Biomedical Engineering Technology, 2023
As a final note, some patients may suffer from “white coat hypertension,” in that they become nervous or agitated when a doctor or nurse approaches, or when undergoing any medical test. The reaction can cause an increase in blood pressure, which is usually temporary. Repeated measurements after the patient relaxes will give more realistic readings.
Towards a blueprint for decision support in connected health: scenarios in maternal and child health
Published in Journal of Decision Systems, 2022
Richard Harris, Eugene Dempsey, Deirdre Murray, Simon Woodworth, Paidi O’Raghallaigh, Frédéric Adam
Hypertension is a common medical disorder of pregnancy, estimated to occur in 6% to 8% of cases. In Ireland and other developed nations, hypertension in pregnancy remains the second cause of maternal mortality, accounting for 16% of maternal deaths (Berg et al., 2003). White Coat Hypertension (WCH) is a common phenomenon when a diagnosis of elevated blood pressure (BP) occurs in the clinical setting but normal BP persists, outside of medical visits (Brown et al., 2005). Clinical blood pressure measurements at scheduled antenatal visits taken by trained professionals are the gold standard for diagnosing and treating hypertension in pregnancy. However, there is increasing evidence to suggest that current BP monitoring is error-prone and that ambulatory BP monitoring in the patient’s own environment is more accurate (Brown et al., 2005; Perry et al., 1991). Patients with persistently elevated BP outside of the clinical setting are more likely to develop pre-eclampsia which, although relatively uncommon, carries great risks for mother and foetus (Sibai, 1996). Thus, accurate identification of individuals with WCH versus those with true hypertension is critical (Bellomo et al., 1999). Despite progress with ambulatory BP devices, they are still intrusive and interfere with normal activities of daily living (Carney, 1997). They also still require visits to the antenatal clinic for review and interpretation (Staessan et al., 1999). As maternity care in Ireland (Health Service Executive, 2010) and other developed countries is split between the family doctor, community or hospital midwife, and obstetrician this can further complicate matters as BP results should be shared within multidisciplinary teams.