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William B. White, MD

Arch Intern Med. 1986;146(11):2196-2199.

Abstract
• To assess the discrepancy between casual (office) and home blood pressure readings in patients performing home blood pressure monitoring, we analyzed office, home, and 24-hour ambulatory blood pressure and heart rates in 19 patients in a prospective four-week study. After the month of study, the average difference between mean office and manual home blood pressures in this office hypertensive group was 30 ±17/20±6 mm Hg. The blood pressures taken in the office were substantially greater than the 24-hour average blood pressures and ambulatory blood pressures during work or while at home (awake). An analysis of the automatic monitor readings while in the doctor's office and at 15-minute intervals after leaving the office showed a progressive reduction in blood pressure and heart rate during the first hour after leaving the office. A mean 24-hour blood pressure of less than 130/80 mm Hg was found in 13 (68%) patients. These data suggest that patients with office hypertension are usually normotensive but may have a persistent and recurrent pressor response in a medical care setting. Ambulatory blood pressure monitoring provides confirmation of not only the office-home disparity, but also suggests that stress other than office visits fails to elicit a hypertensive response.

(Arch Intern Med 1986;146:2196-2199)

Author Affiliations
From the Hypertension Unit, Department of Internal Medicine, University of Connecticut School of Medicine, Farmington.

Footnotes
Accepted for publication Feb 25, 1986.

This work was presented in part at the International Society of Ambulatory Monitoring, Padova, Italy, March 1985.

Reprint requests to L-2071A, University of Connecticut Health Center, Farmington, CT 06032 (Dr White).

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