Difference in blood pressure, but not in heart rate, between measurements performed at a health centre and at a hospital by one and the same physician

Background: Blood pressure (BP) has been found to vary between examiners, f or example it is often higher when measured by a physician than by a nurse. Whether the location for the physician-measured BP is also a source of var iation has, however, not been studied. Hence, we found it of interest to fi nd out if the location used for examination was of any significance. Objective: To explore if BP and/or heart rate measured in the same subjects by the same general practitioner in the health centre and at the hospital, differed. Method: Twenty-five hypertensive and 25 age-matched normotensive middle-age d men had their office BP and heart rate recorded by one and the same femal e general practitioner (IE) who was well known to them, at both the health centre before ambulatory BP equipment was attached to the subject and at th e clinical physiological department before an exercise test. The hypertensi ve patients performed an exercise test and ambulatory BP was measured befor e and after being treated. Results: The hypertensive patients' office BP was lower at the health centr e than at the hospital, both when they were untreated and after they were t reated. The difference (systolic/diastolic (s.d.)) was 9.4/6.0 (7.4/2.7) mm Hg (P < 0.001 for systolic and diastolic BP), when they were untreated. Co rresponding figures when they were treated were 5.4/4.0 (9.4/4.7) mm Hg, a significant difference in diastolic BP (P < 0.001). The normotensive subjec ts also had a lower office BP at the health centre than at the hospital. Th e difference (systolic/diastolic (s.d.) was 1.8/5.3 (7.0/5.0) mm Hg (P < 0. 001 for diastolic BP). Heart rate did not differ between recordings in the health centre and in the hospital, either in the hypertensives or in the no rmotensives. Conclusion: Office BP differed significantly between measurements performed in the health centre and at the hospital. Hence, being examined at a hospi tal seemed to be a stronger stimuli in most patients than to be examined in a health centre. When diagnosing or evaluating treatment in hypertension, this may have implications.