Muscle and skin sympathetic nerve traffic during physician and nurse blood pressure measurement.

摘要: OBJECTIVE Previous studies have shown that blood pressure assessment by a nurse markedly attenuates the pressor and tachicardic responses triggered physician measurement. Whether to what extent this attenuation reflects different pattern of neuroadrenergic doctor or evaluation is unknown. METHODS In 19 lean untreated mild essential hypertensive patients (age 39.1 ± 2.4 years, mean ± SEM), we measured beat-to-beat mean arterial (Finapres), heart rate (ECG), efferent postganglionic muscle skin sympathetic nerve traffic [muscle activity (MSNA) (SSNA), respectively, microneurography], before, during, following 10-min sphygmomanometric BP measurement unfamiliar patients. Measurements were repeated at 30-min interval obtain, in separate periods, recordings. Both sequences (doctor vs. traffic) randomized. RESULTS A visit induced sudden, marked, prolonged increases, accompanied inhibition (average response: -18.1 ± 4.3%, P < 0.01) coupled with excitation +46.1 ± 5.5%, P < 0.01). contrast, elicited significantly reduced (-72.1 ± 11 -81.7 ± 13% as compared those seen during doctor's visit. This was case also for neural (-44.3 ± 9 -65.6 ± 13%, CONCLUSION These data provide first evidence blunted nurse's measurements are an adrenergic alerting reaction accompanying