Abstract:
:Until now, no information is available about the effect of the presence of a doctor-in-training on a patient's blood pressure. We tested the hypothesis that the presence of a last year medical student might increase the blood pressure of the patient, in addition to the possible pressor response to the doctor-trainer. Normotensive and hypertensive patients with a minimum age of 25 years, visiting for any reason, were recruited at 22 teaching general practices. Patients were randomised into a 'trainee' group (n=133) and a 'no trainee' (n=129) group. The blood pressure was measured at two subsequent contacts. In the 'trainee' group, a student was present at the first visit only. In the 'no trainee' group, both visits were without student. Both groups had similar anthropometric characteristics at entry. At the first visit, systolic pressure was higher in the 'trainee' group than in the control group (139.5 vs 133.1 mmHg, P=0.004), with a similar trend for diastolic pressure (80.2 vs 77.8 mmHg, P=0.07). From the first contact to the follow-up visit, blood pressure decreased in the trainee group by 4.8 mmHg systolic (P<0.001) and 1.7 mmHg diastolic (P=0.03), whereas the corresponding changes in the control group were -0.1 mmHg (P=0.90) and +1.5 mmHg (P=0.03). Thus, the between group differences in these trends averaging 4.7 mmHg (CI 1.5-7.9, P=0.005) systolic and 3.2 mmHg (CI 1.1-5.3, P=0.003) diastolic were statistically significant. We conclude that in teaching-practices, the presence of a doctor-in-training has a significant pressor effect when an experienced general practitioner measures a patient's blood pressure. If confirmed, our findings imply that doctors should be cautious to initiate or adjust antihypertensive treatment when blood pressure readings are obtained in the presence of a student.
journal_name
J Hum Hypertensjournal_title
Journal of human hypertensionauthors
Matthys J,De Meyere M,Mervielde I,Knottnerus JA,Den Hond E,Staessen JA,Duprez D,De Maeseneer Jdoi
10.1038/sj.jhh.1001744subject
Has Abstractpub_date
2004-11-01 00:00:00pages
769-73issue
11eissn
0950-9240issn
1476-5527pii
1001744journal_volume
18pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::The objective of the study is to compare fatal and nonfatal cardiovascular endpoints in hypertensive patients randomised to the calcium-channel blocker, nifedipine GITS or a thiazide diuretic, co-amilozide. A total of 6592 patients from nine countries (UK, France, Israel, Spain, Italy, The Netherlands, Sweden, Denmark...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::An impaired renal function has been found associated with very high cardiovascular (CV) risk, especially in subjects with type 2 diabetes. Microalbuminuria is a sensitive early marker of renal damage, often preceding the more advanced stages of diabetic nephropathy. Consistent evidence has been provided that any degre...
journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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更新日期:1990-08-01 00:00:00
abstract::Inconsistent results have been reported regarding the association of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and hypertension. Recent studies of population-based samples of three different areas in Japan presented conflicting results regarding this association. We, thus, investiga...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1001601
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abstract::Electrocardiograph (ECG) criteria for left ventricular hypertrophy (LVH) are a widely used clinical tool. We recalibrated six ECG criteria for LVH against gold-standard cardiac magnetic resonance (CMR) and assessed the impact of obesity. One hundred and fifty consecutive tertiary hypertension clinic referrals for CMR ...
journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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abstract::The aim of the present longitudinal study was to describe determinants of blood pressure (BP) and echocardiographically calculated left ventricular mass in adolescents with a variable risk of future hypertension. BP was measured and M-mode echocardiography was performed in 52 children, 29 male and 23 female, at a mean...
journal_title:Journal of human hypertension
pub_type: 杂志文章
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abstract::In view of the low sensitivity of Sokolow-Lyon voltage criteria in the assessment of electrocardiographic left ventricular hypertrophy (ECG LVH) in overweight subjects, we determined its clinical utility in 1840 lean and 3555 overweight subjects with hypertension. They were followed prospectively over an average of 11...
journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/jhh.2008.102
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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更新日期:1995-03-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,多中心研究
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abstract::To assess the suitability of therapy with an angiotensin-converting enzyme inhibitor for older hypertensives, a randomised double blind two group comparison of enalapril (10 to 40 mg daily) with hydrochlorothiazide (25 to 100 mg daily) was carried out in 32 untreated and independently living subjects aged 63 to 82 yea...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-04-01 00:00:00
abstract::It is important to understand what genetic risk factors lead to hypertension and how genotype-specific dietary and lifestyle modification can mitigate the risk of developing hypertension. The ATP2B1 rs17249754 gene, which encodes a calcium pump expressed in vascular smooth muscle was identified as having variants that...
journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/jhh.2014.2
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2016.81
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract::Despite the availability of multiple nonpharmacological and pharmacological antihypertensive regimens large scale control of BP on a population basis is still unsatisfactory. To achieve a better quality in hypertension care we have developed and evaluated a structured outpatient hypertension treatment and teaching pro...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::The association of single nucleotide polymorphisms (SNPs) from seven candidate genes, including genotype-by-baseline fitness and genotype-by-baseline body mass index (BMI) interactions, with incident hypertension over 20 years was investigated in 2663 participants (1301 blacks, 1362 whites) of the Coronary Artery Risk...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2010.94
更新日期:2011-08-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::The prognostic value of ambulatory blood pressure (BP) monitoring for long-term prognosis varies in recent studies. The study aimed to investigate the role of ambulatory BP parameters in mortality and cardiovascular (CV) events in hypertensive patients. A series of 412 participants (59.3 ± 4.0 years) who received ambu...
journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2010.80
更新日期:2011-07-01 00:00:00
abstract::There is a strong association between cigarette smoking and accelerated hypertension. In mild hypertension smoking cigarettes has a distinct pressor effect and caffeine a small but more prolonged pressor action. Coffee and cigarette smoking together have an additive effect on blood pressure (BP). We have examined the ...
journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-02-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,随机对照试验
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更新日期:2016-01-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00