Approach to the diagnosis of white coat hypertension

This algorithm summarizes an approach to the evaluation of white coat hypertension in a patient with elevated BP. We use the American College of Cardiology/American Heart Association definitions and staging system to classify BP.

ABPM: ambulatory blood pressure monitoring; AOBP: automated office BP measurement; BP: blood pressure; SMBP: self-measured blood pressure.

* If BP >180/120 mmHg, urgent assessment is required to exclude hypertensive emergency and determine the need for inpatient care. Please refer to related UpToDate content for further details.

¶ ABPM is the preferred confirmatory method for white coat hypertension. We prioritize ABPM through clinic-based or mail-order services whenever possible, even when SMBP is more readily available.

Δ Examples of lifestyle modification include regular physical activity, tobacco cessation, maintenance of healthy weight, and limiting alcohol intake. Please refer to related UpToDate content for further details.

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Approach to the diagnosis of white coat hypertension