USE OF AN AUTOMATED BLOOD PRESSURE RECORDING DEVICE, THE BpTRU, TO REDUCE THE “WHITE COAT EFFECT” IN ROUTINE PRACTICE.

Myers MG, Valdivieso MA.
Division of Cardiology, Schulich Heart Centre, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada.

Abstract ››

BACKGROUND: The objective of this report is to combine the data from an earlier adult study with the data from a paediatric study in order to determine the overall accuracy of the BpTRU (BPM-100 model) as compared to the recognized standard, auscultatory mercury sphygmomanometer.

METHODS: Blood pressure measurements taken by an automated BP recording device, the BpTRU (VSM MedTech Ltd., Vancouver, BC, Canada) with the patient alone in the examining room, were compared with the following: (1) BP taken by the patient’s family physician; (2) BP taken on the first visit to a hypertension specialist; (3) BP measured by a trained research technician and (4) the mean awake ambulatory BP (ABP). The BpTRU and trained research technician readings were taken outside of the office (treatment) setting in an ABP research unit.

RESULTS: Blood pressure readings (mm Hg, mean +/- SEM) taken by the BpTRU (155 +/- 5/88 +/- 2) tended to be lower than for the family physician (166 +/- 4/89 +/- 3) and the hypertension specialist (174 +/- 5/92 +/- 2; P <.001). However, BP taken by the trained research technician (158 +/- 4/90 +/- 2) was similar to the value obtained by the BpTRU. The mean awake ABP was lower (P < 0.01) than the other four BP values.

CONCLUSIONS: Use of an automated BP recording device outside of the office (treatment) setting can partly eliminate the white coat effect. A similar finding was observed with readings taken by a trained research technician under similar conditions. Referral of patients to nonoffice settings for automated BP recordings may provide a more accurate estimate of a patient’s BP status, with partial elimination of the white coat effect associated with readings taken by a physician.

Am J Hypertens. 2003 Jun;16(6):494-7.

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