Is BP Lowered in DS by an Environmental Factor?
Low BP in DS patients living inside and outside the hospital suggests that a hospital environmental factor does not entirely explain this phenomenon in DS. Lower BP in DS than in non-DS patients, both living outside the hospital, further suggests that BP is not lowered in DS by an environmental factor acting outside the hospital. Together, data from our study and others [2-4] suggest that although there are factors in the hospital environment that contribute to lower BP, these are not responsible for the low BP in DS. A mechanism related to trisomy 21 is more likely. The cheerful disposition of DS patients, a well-recognized feature of trisomy 21, might contribute to lowering of BP, but we did not design our study to assess this. The similarity of BP values in the presence and absence of doctors (Table 3) also raises the possibility of a diminished white coat pressor response (see [21]) in DS patients, but our observations here were in five patients only.
