Abstract
ObjectiveThe purpose of this study was to assess the effect of headphone use and covariates on indirect radial Doppler flow systolic arterial blood pressure (BP) measurements in dogs.MethodsBetween May and August 2018, 100 privately-owned dogs were enrolled. Blood pressure was measured in lateral recumbency, with and without headphones, using a randomized crossover design. The initial BP, mean of BP 2-6, weight, BCS, MCS, anxiety score, and heart rate were recorded. Mixed effects crossover analyses and Spearman rank correlation coefficients were determined.ResultsEighty-four dogs completed the study. Eleven dogs were removed due to excessive anxiety, 10 of which were in the non-headphone first group. The number of dogs diagnosed as hypertensive did not differ between measurement types (19 vs. 18), with seven dogs categorized as hypertensive during both periods. Significant differences in BP were identified (F[1, 80] = 4.3, P = 0.04) due to higher results for measurements taken without headphones for BP 1, but not BP 2-6. Systolic BP was positively correlated with anxiety score, age, and weight.Conclusions and Clinical RelevanceThough BP 1 was significantly higher when taken without headphones, this pattern did not persist for BP 2-6. Lack of association between BP 2-6 results and measurement type could reflect exclusion of dogs most sensitive to white coat hypertension, acclimation to technique, or improved sound quality of headphones. Given significantly higher BP 1 results and disproportionate exclusion of dogs due to anxiety when measurements first were taken without headphones, use of headphones is recommended to improve accuracy of results.
Highlights
Excitement or anxiety associated with the process of veterinary evaluation and blood pressure measurement can activate the central nervous system and increase systolic blood pressure, a phenomenon known as the white-coat effect or white-coat hypertension (Belew, Barlett & Brown, 1999; Bragg et al, 2015; Höglund et al, 2012)
Demographic information and results of each blood pressure measurement series are listed in Table 1, while information for each dog is presented in File S1
Consistent with prior reports (Acierno et al, 2018; Mooney et al, 2017), we found no association between body condition score (BCS) and blood pressure in the mixed model analysis
Summary
Excitement or anxiety associated with the process of veterinary evaluation and blood pressure measurement can activate the central nervous system and increase systolic blood pressure, a phenomenon known as the white-coat effect or white-coat hypertension (Belew, Barlett & Brown, 1999; Bragg et al, 2015; Höglund et al, 2012). There was no significant difference in white-coat effect among five simulated office visits for healthy research cats undergoing repeated indirect oscillometric blood pressure measurement after physical examination, the magnitude of the white-coat effect was lowest during the first visit for 3/6 cats (Belew, Barlett & Brown, 1999). Accurate blood pressure determination is essential to identify the presence of hypertension and need for intervention (Höglund et al, 2012)
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