Situational anxiety and blood pressure lability in the physician's office.

In order to evaluate the association between situational anxiety levels and blood pressure variability during physician's office visits, 19 patients were assessed at the beginning of the visit and before and after being examined by the physician. Assessment included blood pressure measurement as well as self-report of current anxiety level. Previous findings that systolic readings do significantly diminish over the course of the visit were replicated for both hypertensive and normotensive patients, accompanied by correlative decreases in state anxiety. Diastolic blood pressure readings were more stable and less associated with fluctuations in state anxiety, except in patients with initially higher diastolic readings. Results were interpreted as indicating the importance of using more than one blood pressure measurement in diagnosing hypertension and monitoring its management. In particular, patients' anxiety responses upon entering the examining room may produce artificial elevations.