![]() ![]() ![]() What new evidence supported changing the BP cutoff for hypertension to 130/80 mm Hg? Nine trials contributed to the ACC/AHA meta-analysis on which the guideline was based. Our current approach to routine office BP measurement should not be used to implement the targets recommended in this guideline. This approach was used in the SPRINT trial (Systolic Blood Pressure Intervention Trial) 6 that was cited in the ACC/AHA guideline. BP readings obtained with this method are 5 to 10 mm Hg lower than with techniques that involve a clinician, and they more closely reflect out-of-office readings. 2, 4 Enthusiasm is increasing for automated office BP meaurement, 5 which duplicates the process described in Table 1 but does so without a clinician in the examination room. Even a properly obtained office BP measurement is suboptimal for the diagnosis or management of hypertension out-of-office readings using 12- to 24-hour ambulatory or home BP monitoring provide the best guidance. Properly obtained measurements have been the standard in clinical trials, but require about 10 minutes and are not routinely obtained in the office setting ( Table 1). The new ACC/AHA guideline appropriately addresses BP measurement. BP is a dynamic-not static-measurement, and varies based on when, where, and how it is measured.
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