INFLUENCE OF PLACE AND PERSON WHO PERFORM S THE PROCEDURE IN THE CONTROL AND DIAGNOSIS OF HBP

The use of ambulatory monitorization of blood pressure has shown the i mportance of the alarm reaction or white coat reaction and its conditi oning factors in some patients. The influence of place (medical facili ty or home) and person who performs the procedure (doctor or nurse) on the taking of blood pressure is studied with regard to degree of cont rol and/or disease diagnosis. The design is descriptive with a cross-s ection analysis. The sample is made up of 100 people-50 with hypertens ion and 50 who came to the center for reasons unrelated to blood press ure and were selected at random. Of the results obtained, the findings below are noteworthy. The number of controlled hypertension cases is fewer in the medical consultation (18 percent) or with nursing staff ( 22 percent) than in the patients' homes, whether the procedure is perf ormed by the doctor (54 percent) or by the nurse (58 percent) (p=0.000 004). In the group of individuals who sought consultation, the number of hypertension cases detected by random measurements is fewer in the medical consultation (66 percent) than by the nursing staff (48 percen t) and lowers significantly at home (p=0.000001), whether taken by the doctor (22 percent) or by the nurse (20 percent). It is confirmed tha t figures for blood pressure at home are lower than those registered i n the consultation, be they taken by the doctor or the nurse. We belie ve that the elevation in blood pressure is not exclusively attributabl e to the doctor and suggest that place where the procedure is performe d is more important than the person who performs the procedure.