16
Evaluation and Diagnosis
Table 9. Blood Pressure Categories Based on Office and
Out-of-Office Blood Pressure Measurements
BP category
High BP in the
office setting?
High BP outside of
the office setting?*
Among individuals not taking antihypertensive medication
Sustained normotension No No
Sustained hypertension Yes Yes
Masked hypertension No Yes
White-coat hypertension Yes No
Among individuals taking antihypertensive medication
Controlled hypertension No No
Uncontrolled hypertension Yes Yes
Masked uncontrolled hypertension No Yes
White-coat effect Yes No
* Please refer to Table 7 for office BP and out-of-office BP thresholds used to define high BP.
High out-of-office BP is defined as SBP ≥130 mm Hg or DBP ≥80 mm Hg when using awake
BP and SBP ≥125 mm Hg or DBP ≥75 mm Hg when using 24-hour BP. ese BP thresholds
correspond to an office SBP ≥130 mm Hg or DBP ≥80 mm Hg. Out-of-office BP is primarily
based on mean awake BP or mean 24-hour BP. It remains unclear whether asleep BP should
be used to determine high out-of-office BP as the prevalence and reproducibility of isolated
nocturnal hypertension (high asleep BP without high awake BP) are both low. Further, there is
no high-quality RCT evidence to indicate that lowering asleep BP reduces CVD risk.
Modified with permission from Whelton et al. Copyright © 2018 American College of
Cardiolog y Foundation and American Heart Association, Inc.
