Integrating Out-of-Office Blood Pressure in the Diagnosis and Management of Hypertension.
Guidelines for the diagnosis and monitoring of hypertension were historically based on in-office blood pressure measurements. However, the US Preventive Services Task Force recently expanded their recommendations on screening for hypertension to include out-of-office blood pressure measurements to confirm the diagnosis of hypertension. Out-of-office blood pressure monitoring modalities, including ambulatory blood pressure monitoring and home blood pressure monitoring, are important tools in distinguishing between normotension, masked hypertension, white-coat hypertension, and sustained (including uncontrolled or drug-resistant) hypertension. Compared to in-office readings, out-of-office blood pressures are a greater predictor of renal and cardiac morbidity and mortality. There are multiple barriers to the implementation of out-of-office blood pressure monitoring which need to be overcome in order to promote more widespread use of these modalities.
Renal, Electrolyte and Hypertension Division, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, Philadelphia, PA, 19104, USA. jco@mail.med.upenn.edu.
Jordana B
JB
Cohen
Renal, Electrolyte and Hypertension Division, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, Philadelphia, PA, 19104, USA.
Debbie L
DL
Cohen
D001795:Blood Pressure Determination / Q000379:methods* / Q000523:psychology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods* / Q000523:psychology; D003362:Cost-Benefit Analysis; D006801:Humans; D059468:Masked Hypertension / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D009819:Office Visits / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012648:Self Care; D014481:United States; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control
Ambulatory blood pressure monitoring; Home blood pressure monitoring; Hypertension screening; Masked hypertension; White-coat hypertension
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