Can the pressor response accompanying blood pressure measurement be limited in young, normotensive women?

Background: A decrease in blood pressure (BP) values observed over consecutive measurements may lead to significant discrepancies, affecting individual diagnostic and therapeutic decision making. The goal of the study was to assess whether it was possible to limit or eliminate the tendency for BP values to decline in successive measurements.

Methods: In a group of 148 normotensive women aged 21.6+/-1.5 years, two series (S1, S2) consisting of three brachial BP measurements each (I, II, and III) were performed, using an Omron 907 oscillometric manometer.

Results: Systolic blood pressure (SBP) (mmHg) was higher in measurement I than in II and III, in both S1 and S2: S1-I: 114.9+/-10.5 vs. S1-II: 112.6+/-9.9, P<0.00003, vs. S1-III: 111.0+/-9.6, P<0.000001; S2-I: 111.5+/-9.8 vs. S2-II: 110.1+/-9.1 P<0.007, vs. S2-III: 110.1+/-9.2, P<0.0008. Furthermore, measurement II was higher than III in S1 (P<0.002). Similarly, diastolic blood pressure (mmHg) was higher in measurement I than in II and III, in both S1 and S2: S1-I: 68.3+/-8.4 vs. S1-II: 67.3+/-8.7, P<0.008, vs. S1-III: 65.7+/-8.7, P<0.000001; S2-I: 66.6+/-8.3 vs. S2-II: 65.8+/-8.2, P<0.04, vs. S2-III: 65.7+/-8.7, P<0.02. Measurement II was again higher than III in S1 (P<0.00003).

Conclusions: The common alerting reaction to BP measurements cannot be avoided in young, normotensive women, but it can be limited, as demonstrated by the results of BP measurements in S2. The simple procedure of automatic cuff inflation and noninvasive, oscillometric BP measurement may carry an independent pressor effect, which corrupts the accuracy of BP measurements.