Talking effect and "white coat" effect in hypertensive patients: Physical effort or emotional content?

Talking has been shown to increase blood pressure instantaneously in hyper- tensive patients and to contribute to the white coat effect. The effects of talking were compared with those of counting aloud in 64 patients with ess ential hypertension who were randomly assigned to a period of stress talkin g and a period of counting aloud (active periods), alternating with three p eriods of silence (control). The same monitor was used for office measureme nts and 24-hour ambulatory blood pressure analysis. Systolic/diastolic bloo d pressures increased significantly more during talking (163/110 mmHg) than during counting aloud (152/102 mmHg, both p < .0001) in both treated and u ntreated patients and in sustained and clinical hypertension. Talking had a residual effect on systolic blood pressure that lasted 5.8 +/- 0.1 minutes . The emotional content seemed to be the only cause of the talking effect. Its instantaneous and residual effects on blood pressure and heart rate sho uld be considered when measuring these variables.