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The arousal reaction in any patient coming to see a doctor (white
coat effect) is such that the blood pressure measurements taken at any
time, with or without medical students around, except when the patient is
unconscious, should be inaccurate. It is usually much higher than the
actual pressure. Adjusting drug dosage to clinic pressure readings, even
after more than one measurement could, consequently, be dangerous.
Normal blood pressures in the clinic could go down further when the
patient goes to sleep. If the diastolic pressures fall, even marginally in
deep sleep, coronary filling could suffer (especially in those with
compromised coronary circulation) resulting in myocardial infarctions in
sleep!The dew could flood the ant's house!
In the ant's house, the dew is a flood
Dear Editor,
The arousal reaction in any patient coming to see a doctor (white
coat effect) is such that the blood pressure measurements taken at any
time, with or without medical students around, except when the patient is
unconscious, should be inaccurate. It is usually much higher than the
actual pressure. Adjusting drug dosage to clinic pressure readings, even
after more than one measurement could, consequently, be dangerous.
Normal blood pressures in the clinic could go down further when the
patient goes to sleep. If the diastolic pressures fall, even marginally in
deep sleep, coronary filling could suffer (especially in those with
compromised coronary circulation) resulting in myocardial infarctions in
sleep!The dew could flood the ant's house!
yours ever,
bmhegde
Competing interests:
None declared
Competing interests: No competing interests