Photographic art in exam rooms may reduce white coat hypertension.

INTRODUCTION: Blood pressure (BP) elevation in medical office settings in patients who are normotensive in nonmedical settings is an effect known as 'white coat hypertension'. This phenomenon is thought to be due to situational anxiety caused by the experience of visiting a doctor and the anxiety-inducing nature of the medical office. Our study was designed to determine if carefully selected photographic art could counter the anxiety that causes white coat hypertension and lead to lower BP recordings in some patients. METHODS: 117 adults, non-pregnant patients from the Louisiana State University Health Sciences Center Family Medicine Resident Clinic participated in this study. After the triage nurse measured the BP, the patients were randomly placed in either an exam room with standard medical posters (control room) or in an exam room with photographic art (photo room). The BP was measured in the exam room. After the medical visit, the patients switched rooms and the BP was measured a third time. The patients were asked to fill out a questionnaire to identify room preference. RESULTS: On average, the BP obtained in the control rooms was higher than that obtained in the photo rooms. There was a statistically significant difference between the mean arterial pressure, systolic BP and diastolic BP between the control room and the photo room. CONCLUSIONS: Landscape photographic art may have the beneficial effect of reducing BP in medical office examination rooms.

Environmental control of allergic diseases.

Allergic disease affects millions of persons in the United States. Environmental control measures are essential for persons who are sensitive to dust mite and cat allergens and may be important in persons who are sensitive to cockroaches and fungus. The bedroom is the most important room in which to implement environmental control measures, such as encasing mattresses and pillows in vinyl or semipermeable covers. Patients with asthma (especially persistent asthma) should be considered for allergy testing and more aggressive environmental control measures. Carpet in the bedroom or over concrete should be removed. For persons who are sensitive to pet allergens, permanent removal of the pet is recommended. Dust mite and fungus growth can be controlled by keeping the household humidity level at less than 50 percent. Removing sources of food and water and using insecticides will help control cockroach populations. Patients who are sensitive to mold and outdoor air pollution should consider limiting outdoor activities when these levels are high. Patients with asthma should avoid exposure to tobacco smoke. (Am Fam Physician 2002;66:429-30.)