Dr Paul Whelton Outlines the Importance of Out-of-Office Blood Pressure Measurements

The time a patient is in a doctor's office represents a very small window of the body normally, which makes out-of-office blood pressure measurements important to confirm diagnosis of hypertension, explained Paul Whelton, MD, MSc, professor of global public health at Tulane University.

The new hypertension guideline emphasizes the need for measuring blood pressure when patients are not in the physician's office. Why is this important?
The measurement is very important. Obviously, we're going to make key decisions to label somebody as having high blood pressure and to maybe instigate therapy—lifestyle or drugs. And so we emphasize accurate measurements of blood pressure. we emphasize getting the average estimate of blood pressure, and we emphasize out-of-office blood pressure measurements, because we realize that once you get in the office, there's a very narrow window of what the body sees. So, it's important to get out-of-office measures to confirm the diagnosis of hypertension in the office, and to recognize white coat hypertension, or to recognize, more importantly, masked hypertension.

So for all of those reasons, we've put a strong emphasis on out-of-office blood pressure measurements. And, of course, in the United States, that's mostly going to be home blood pressure measurements, so the patient needs to be instructed how to get accurate measuremnts.
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