Document Detail


Frequent nurse visits decrease white coat effect in stage III hypertension.
MedLine Citation:
PMID:  15177526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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).
Authors:
Grazia Maria Guerra-Riccio; Dante Marcelo Artigas Giorgi; Fernanda Marciano Consolin-Colombo; José Augusto Soares Barreto-Filho; Heno Ferreira Lopes; Ana Lúcia Rego Fleury Camargo; Eduardo Moacyr Krieger
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  17     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-04     Completed Date:  2004-11-06     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  523-8     Citation Subset:  IM    
Affiliation:
Hypertension Unit-Heart Institute, Faculty of Medicine of the University of São Paulo, São Paulo SP, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Ambulatory Care*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects,  physiology
Blood Pressure Monitoring, Ambulatory
Brazil
Calcium Channel Blockers / therapeutic use
Circadian Rhythm / drug effects,  physiology
Diastole / drug effects,  physiology
Female
Follow-Up Studies
Humans
Hypertension / nursing*,  physiopathology
Male
Middle Aged
Severity of Illness Index
Systole / drug effects,  physiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers

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