Most clinicians rely on clinic- or home-based measurement of blood pressure (BP) for diagnosing hypertension. However, whether such measurements are accurate is unclear.
In this systematic review and meta-analysis of 20 studies that involved 5700 patients, U.K. investigators determined how accurately clinic- and home-based BP measurements diagnosed hypertension; daytime ambulatory BP measurements were the reference standard. The studies varied in the number of BP measurements obtained for ambulatory, clinic, and home monitoring.
These results have important implications! Many people with diagnosed hypertension are not really hypertensive, especially if the diagnoses were based on clinic BP measurements (i.e., white-coat hypertension). The study investigators suggest using clinic- or home-based BP measurements to screen for hypertension, followed by ambulatory BP measurement to diagnose hypertension so that unnecessary antihypertensive treatment can be avoided. Notably, Medicare reimburses for 24-hour ambulatory BP measurements only in patients with white-coat hypertension.
Source: Journal Watch General Medicine