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Patients with hypertension who are regularly monitored by a nurse achieve better control over their condition than people who don't see a nurse, new study findings suggest. Frequent visits with a nurse also seem to weaken the effect of so-called white-coat hypertension, a stress-related rise in blood pressure (BP) triggered by the sight of clinicians dressed in lab coats. Although white-coat hypertension can be benign, it may lead to target organ damage similar to that found in patients with established hypertension or progress to established hypertension.
In this 6-month Brazilian study, nurses visited one group of 48 patients with hypertension every 15 days and a second group of 52 similar patients every 90 days. All patients were taking BP medication. Nurses measured patients' BP at each visit and reminded them to adhere to their treatment program.
In the group that saw a nurse every 15 days, initial BP readings were 191/122 at the start of the study. After 6 months, systolic readings dropped by about 36 points and diastolic readings dropped by about 21 points.
In the group that saw a nurse less frequently, initial readings averaged 186/117. After 6 months, systolic readings dropped by about 17 points and diastolic readings dropped by about 10 points.
Periodically, all patients also wore a portable BP monitor for 24-hour periods. Those who saw a nurse more frequently had a smaller difference between their 24-hour readings and their office visit readings than people who saw a nurse less frequently. Researchers speculate that seeing a nurse more frequently may help lessen the white-coat effect, improving clinicians' ability to diagnose and treat patients appropriately.
"Frequent Nurse Visits Decrease White Coat Effect in Stage III Hypertension," American Journal of Hypertension, G. Guerra-Riccio, et al., June 2004.
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