People with suspected hypertension should have
Leung AA, Nerenberg K, Daskalopoulou SS, et al. Hypertension Canada’s 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension. Can J Cardiol. 2016; 32(5): 569-588. doi: 10.1016/j.cjca.2016.02.066.
If the visit 1 mean non-AOBP SBP is 140-179 mm Hg and/or DBP is 90-109 mm Hg or the mean AOBP SBP is 135-179 mm Hg and/or DBP is 85-109 mm Hg, out-of office BP measurements should be performed before visit 2 (Grade C).
i. Ambulatory BP monitoring is the recommended out of-office measurement method (Grade D). Patients can be diagnosed with hypertension according to the thresholds outlined in section I, recommendation 3.
ii. Home BP monitoring is recommended if ambulatory BP monitoring is not tolerated, not readily available, or because of patient preference (Grade D). Patients can be diagnosed with hypertension according to the thresholds outlined in section I, recommendation 3.
iii. If the out-of-office BP average is not elevated, white coat hypertension should be diagnosed and pharmacologic treatment should not be instituted (Grade C).
When white coat hypertension is suggested by home BP monitoring, its presence should be confirmed by repeat home BP monitoring (Recommendation 7 in this section) or ambulatory BP monitoring before treatment decisions are made (Grade D).
National Heart Foundation of Australia. Guideline for the diagnosis and management of hypertension in adults – 2016. Melbourne: National Heart Foundation of Australia, 2016.
Table 4.1 (page 17)
National Institute for Health and Care Excellence (NICE). Hypertension in adults: Diagnosis and management 2011. Available from: nice.org.uk/guidance/cg127. Accessed: August 2017.
If blood pressure measured in the clinic is 140/90 mmHg or higher: