The Importance of Accurate Blood Pressure Measurement

Joel handler, Md, is an expert Panel Member of the eighth Joint national committee on High Blood Pressure; Hypertension clinical lead, care Management institute; and Hypertension lead for Southern california Kaiser Permanente, anaheim, ca. e-mail: joel.handler@kp.org. Clinical Scenario A woman, age 72 years, has blood pressures of 150/70 mm Hg and 150/80 mm Hg, obtained by a medical assistant (MA), on consecutive office visits and does not have a history of hypertension. The blood pressure cuff is properly sized, the MA is inquiring about the patient’s last mammogram while obtaining the blood pressure, and the patient is helping to hold her arm up within the MA’s grasp. The mean of a dozen blood pressure readings that the patient has obtained at home is 128/64 mm Hg. Does this patient have white-coat hypertension?