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Invited Commentary
July 11, 2011

Home Blood Pressure Monitoring as an Intervention to Control HypertensionComment on “Home Blood Pressure Management and Improved Blood Pressure Control”

Author Affiliations

Author Affiliations: Division of Hypertension and Clinical Pharmacology (Dr White) and Center for Behavioral Cardiology (Dr Petry), Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington.

Arch Intern Med. 2011;171(13):1181-1182. doi:10.1001/archinternmed.2011.292

Out-of-office monitoring of the blood pressure (BP) can provide unique information that may be of help both for making treatment decisions and for evaluating the response to treatment.1 The mainstay for the justification of out-of-office BP monitoring is that there is steadily increasing and substantial evidence that both ambulatory and home BP measurements give a better prediction of risk when compared with office BP monitoring.27 This has been shown in studies that used ambulatory BP measurements13 as well as those that used home (or self) monitoring of the BP.46 In general, when there is a discrepancy between the in-office BP and the out-of-office BP, the risk follows the latter more closely. Thus, patients with “white-coat hypertension” (high BP in the physician's office and normal BP out of the office) are at relatively low risk,2,4 whereas patients whose out-of-office BP is higher than anticipated from the office BP are at relatively high risk.3,8 Even in treated patients with hypertension, a high out-of-office BP is a marker for increased risk.

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