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

REVIEW, August 2011, VOL I ISSUE IV, ISSN 2042-4884
10.5083/ejcm.20424884.49 , Cite or Link Using DOI
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José Boggia, Tine W.Hansen, Kei Asayama, Leonella Luzardo, Yan Li, Jan A. Staessen


White-coat hypertension is a condition in which an individual is hypertensive during repeated blood pressure measurement in the clinical setting, but blood pressure measured outside the medical environment by ambulatory blood pressure monitoring or self blood pressure measurement at home are normal. With the increasing availability of ambulatory techniques many physicians are faced with the diagnosis of white-coat hypertension. The aim of this review is to summarise the current literature on white-coat hypertension on ambulatory monitoring and self blood pressure measurement at home.


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’. 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).