White-coat Hypertension on Automated Blood Pressure Measurement: Implications for Clinical Practice

In 2002, Thomas G. Pickering wrote, ‘the addition of ambulatory blood pressure monitoring to conventional clinic measurement for defining blood pressure (BP) status in clinical practice has added a new complexity to the process, because the separation of normotension and hypertension can be assessed independently by each of the two methods’[1]. The two groups of patients that arise from this classification and require special attention are individuals with white-coat hypertension and those with masked hypertension. Self measurement of BP at home is increasingly becoming an alternative to ambulatory blood pressure monitoring. The 2007 European Guidelines recommend the same threshold for daytime ambulatory BP monitoring and self measurement of blood pressure (135/85 mmHg).