EFFECT OF MENTAL RELAXATION ON OFFICE BLOOD PRESSURE MEASUREMENT BY OSCILLOMETRY

Abstract

Objective: Automated office Blood pressure (AOBP) has become the standard of care method of measuring blood pressure. ESC/ESH Clinical Practice Guidelines for the management of arterial hypertension 2018 specifies that Patients should be seated comfortably in a quiet environment for 5 min before beginning BP measurements. However, a variety of visual and auditory stimuli during this period can still result in higher BP recordings. Mental Relaxation induced by reducing visual stimuli and soothing sounds can potentially have an effect on the AOBP recordings. The study aims to evaluate this effect and compare it to the standard protocol of BP measurement. Design and method: 198 consecutive patients were evaluated in the outpatient department. BP was measured by oscillometric method using Microlife BP device following the ESC/ESH guidelines. Patients were seated in a comfortable posture with back and feet supported for a period of 15 minutes before BP measurement. Mental relaxation was induced by reducing visual stimuli using eye shades and ear phones playing soft natural sounds and second set of BP and pulse recordings were done at the end of 5 minutes of relaxation time. Unpaired t test and Chi-Square test were utilized for the statistical analysis. Results: There were 96 males and 102 females with mean age of 53.13 ± 13.95 yrs History of hypertension was present in 105 subjects Using standard BP measurement protocol the mean systolic BP was 142.33 ± 18.85 mm hg, mean diastolic BP was 83.22 ± 8.5 mm hg and mean pulse rate was 84.55 ± 15.27 per minute. The mean change after Mental relaxation augmented period was 6.71 ± 13.66 mm hg in systolic BP (p value 0.0001), 2.85 ± 7.67 mm hg in diastolic BP (p value 0.0001) and 2.81 ± 8.71 per minute in pulse rate (p value 0.0001) Conclusions: Mental relaxation augmented physical rest before measurement of BP by oscillometric method in outpatient clinic results in significant reduction in BP (both systolic and diastolic) and pulse rate compared to standard BP measurement protocol. These values may be more realistic as they are likely to have reduced white coat effect and environmental influences.