Talking with a doctor during a visit elicits increases in systolic and diastolic blood pressure.

OBJECTIVE: To investigate the impact of talking with doctors on blood pressure (BP) in outpatients.

PATIENTS AND METHODS: This study included 122 hypertensive and 78 normotensive outpatients. BP was measured initially in silence with oscillometric BP monitors three times at 1-min intervals as follows: pre-1, pre-2, and pre-3. BP was then measured with the same device immediately, at 3 min, and at 5 min after talking commenced as follows: during-1, during-3, and during-5. When talking stopped, BP was measured again as post-1, post-3, and post-5. The increments in BP and heart rate (HR) were the differences during and pre-3 values.

RESULTS: Systolic blood pressure/diastolic blood pressure (SBP/DBP) increased significantly at 1 min during talking compared with pre-3 values. The maximum increment of SBP was 9.1 mmHg, occurring at 3 min and continuing up to 5 min during the talking stage. The maximum increment of DBP was 4.5 mmHg and that of HR was 2.7 bpm, both occurring at 1 min. When talking stopped, the SBP and DBP significantly decreased immediately. SBP at 5 min, DBP at 3 min, and HR at 1 min were similar to their pre-3 values. Logistic multifactor analysis showed that pre-SBP3 level (R=0.141, P=0.023) was an independent factor, but anxiety scale, age, sex, BMI, and hypertension history were not independent factors.

CONCLUSION: The maximum SBP increment is 9.1 mmHg and DBP increment is 4.5 mmHg during 5 min of talking with doctor. Meanwhile, the increased SBP needs about 5 min to return to the baseline level.