Should Out-of-Office Monitoring Be Performed for Detecting White Coat Hypertension?
Authors: Daichi Shimbo, Paul Muntner
Journal: Annals of Internal Medicine (2019)

Editorials18 June 2019Should Out-of-Office Monitoring Be Performed for Detecting White Coat Hypertension?Daichi Shimbo, MD and Paul Muntner, PhDDaichi Shimbo, MDColumbia University Medical Center, New York, New York (D.S.) and Paul Muntner, PhDUniversity of Alabama at Birmingham, Birmingham, Alabama (P.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1134 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The only certainty is that nothing is certain.—Pliny the Elder, book II, section 7, Natural HistoryOffice blood pressure (BP) measurements have been the primary method for identifying persons with hypertension and monitoring their response to antihypertensive medication. Blood pressure measured in the office setting may differ substantially from BP measured outside of it, and several studies have demonstrated that out-of-office BP measured by ambulatory and home BP monitoring has a stronger association with a person's risk for cardiovascular disease (CVD) events than office BP measurement (1).Four phenotypes have been defined by cross-classifying office BP and out-of-office BP. Two ...References1. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;71:e127-e248. [PMID: 29146535] doi:10.1016/j.jacc.2017.11.006 CrossrefMedlineGoogle Scholar2. Fagard RH, Van Den Broeke C, De Cort P. Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice. J Hum Hypertens. 2005;19:801-7. [PMID: 15959536] CrossrefMedlineGoogle Scholar3. Verdecchia P, Porcellati C, Schillaci G, Borgioni C, Ciucci A, Battistelli M, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension. 1994;24:793-801. [PMID: 7995639] CrossrefMedlineGoogle Scholar4. Krause T, Lovibond K, Caulfield M, McCormack T, Williams B; Guideline Development Group. Management of hypertension: summary of NICE guidance. BMJ. 2011;343:d4891. [PMID: 21868454] doi:10.1136/bmj.d4891 CrossrefMedlineGoogle Scholar5. Siu AL; U.S. Preventive Services Task Force. Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:778-86. [PMID: 26458123]. doi:10.7326/M15-2223 LinkGoogle Scholar6. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021-104. [PMID: 30165516] doi:10.1093/eurheartj/ehy339 CrossrefMedlineGoogle Scholar7. Cohen JB, Lotito MJ, Trivedi UK, Denker MG, Cohen DL, Townsend RR. Cardiovascular events and mortality in white coat hypertension. A systematic review and meta-analysis. Ann Intern Med. 2019;170:853-62. doi:10.7326/M19-0223 LinkGoogle Scholar8. Franklin SS, Thijs L, Asayama K, Li Y, Hansen TW, Boggia J, et al; IDACO Investigators. The cardiovascular risk of white-coat hypertension. J Am Coll Cardiol. 2016;68:2033-43. [PMID: 27810041] doi:10.1016/j.jacc.2016.08.035 CrossrefMedlineGoogle Scholar9. Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47:846-53. [PMID: 16567588] CrossrefMedlineGoogle Scholar10. Stergiou GS, Asayama K, Thijs L, Kollias A, Niiranen TJ, Hozawa A, et al; International Database on HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO) Investigators. Prognosis of white-coat and masked hypertension: International Database of HOme blood pressure in relation to Cardiovascular Outcome. Hypertension. 2014;63:675-82. [PMID: 24420553] doi:10.1161/HYPERTENSIONAHA.113.02741 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Columbia University Medical Center, New York, New York (D.S.)University of Alabama at Birmingham, Birmingham, Alabama (P.M.)Disclaimer: The National Institutes of Health (NIH) had no role in the design of the study; the collection, analysis, and interpretation of the data; or the decision to approve publication of the finished manuscript.Grant Support: By NIH grants R01 HL136445, R01 HL139716, R01 HL047540, and K24 HL125704 from the National Heart, Lung, and Blood Institute.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1134.Corresponding Author: Daichi Shimbo, MD, Columbia University Medical Center, 622 West 168th Street, PH 9-310, New York, NY 10032; e-mail, [email protected]columbia.edu.Current Author Addresses: Dr. Shimbo: Columbia University Medical Center, 622 West 168th Street, PH 9-310, New York, NY 10032.Dr. Muntner: University of Alabama at Birmingham, Department of Epidemiology, 1665 University Boulevard, Suite 230J, Birmingham, AL 35294.This article was published at Annals.org on 11 June 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCardiovascular Events and Mortality in White Coat Hypertension Jordana B. Cohen , Michael J. Lotito , Usha K. Trivedi , Matthew G. Denker , Debbie L. Cohen , and Raymond R. Townsend Metrics Cited byPredicting Out-of-Office Blood Pressure in a Diverse US PopulationManagement of Blood Pressure in Patients With Chronic Kidney Disease Not Receiving Dialysis: Synopsis of the 2021 KDIGO Clinical Practice GuidelineCharles R.V. Tomson, MA, BM, BCh, DM, Alfred K. Cheung, MD, Johannes F.E. Mann, MD, Tara I. Chang, MD, MS, William C. Cushman, MD, Susan L. Furth, MD, PhD, Fan Fan Hou, MD, PhD, Gregory A. Knoll, MD, MSc, Paul Muntner, PhD, MHS, Roberto Pecoits-Filho, MD, PhD, Sheldon W. Tobe, MD, MScCH (HPTE), Lyubov Lytvyn, BSc, MSc, Jonathan C. Craig, MBChB, DipCH, M Med (Clin Epi), PhD, David J. Tunnicliffe, PhD, Martin Howell, PhD, Marcello Tonelli, MD, SM, MSc, Michael Cheung, MA, Amy Earley, BS, Joachim H. Ix, MD, MAS, and Mark J. Sarnak, MD, MSLifestyle Behaviors Among Adults Recommended for Ambulatory Blood Pressure Monitoring According to the 2017 ACC/AHA Blood Pressure GuidelineNew aspects in the management of hypertension in the digital eraScreening for Hypertension in AdultsScreening for Hypertension in AdultsKDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney DiseaseSelf-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical AssociationEvaluation of Hypertension 18 June 2019Volume 170, Issue 12Page: 890-892KeywordsBlood pressureCardiovascular diseasesDisclosureHazard ratioHeartHypertensionMortalityPhenotypesStrokeSystematic reviews ePublished: 11 June 2019 Issue Published: 18 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...