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- Title
Frequent nurse visits decrease white coat effect in stage III hypertension
- Authors
Guerra-Riccio, GraziaMaria; Artigas Giorgi, DanteMarcelo; Consolin-Colombo, FernandaMarciano; Barreto-Filho, JoséAugustoSoares; Lopes, HenoFerreira; Fleury Camargo, Ana L.úciaRego; Moacyr Krieger, Eduardo
- Abstract
Arterial hypertension is a public health problem and patient adherence to treatment is challenging. This study tested whether frequent nurse visits provide additional benefits to antihypertensive treatment. Every 30 days, a pharmacist visited these patients to deliver antihypertensive drugs and perform a pill count. Nurses visited group A (48 patients) every 15 days and group B (52 patients) every 90 days. Ambulatory blood pressure (BP) monitoring was performed 15 and 180 days after randomization. At randomization, groups A and B had the same clinical systolic (191 ± 5 v 186 ± 3 mm Hg) and diastolic BP levels (122 ± 3 v 117 ± 4 mm Hg), respectively. After 90 days, BP declined more in group A than in group B (35 ± 5/19 ± 3 v 27 ± 5/9 ± 3 mm Hg). At 180 days, the difference increased because the reduction persisted in group A but decreased in group B (36 ± 6/21 ± 4 v 17 ± 4/10 ± 2 mm Hg). The mean ambulatory BP monitoring values were similar in both groups at 15 and 180 days. However, the attenuation of the clinic–daytime BP difference was larger in group A than in group B (systolic, -13 ± 4 v -3 ± 4 mm Hg; diastolic -11 ± 3 v -4 ± 3 mm Hg). The patients with clinic–daytime differences decreased more in group A (systolic, 16 to 10; diastolic, 20 to 14) than in group B (systolic, 19 and 20; diastolic, 22 and 22). These data indicate that frequent nurse visits significantly attenuate the white coat effect (clinic daytime BP difference).
- Subjects
FEAR of doctors; ARTERIES; HYPERTENSION; PUBLIC health
- Publication
American Journal of Hypertension, 2004, Vol 17, Issue 6, p523
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1016/j.amjhyper.2004.02.007