PEBC MCQ Hypertension & Dyslipidemia question: BP at home in duplicate twice daily with a validated device

PEBC MCQHypertension & Dyslipidemia

LM, 61, had an office reading of 142/88 mm Hg. Over the next week she measured her BP at home in duplicate twice daily with a validated device, averaging 126/78 mm Hg. How should these results be interpreted?

a. Hypertension confirmed, since the home average is above 120/80 mm Hg
b. Masked hypertension; repeat home readings for another month
c. Hypertension confirmed, since the office value is above 140/90 mm Hg
d. White coat hypertension; continue regular BP monitoring

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Answer: d. White coat hypertension; continue regular BP monitoring

The guideline defines hypertension as BP 130/80 mm Hg or higher measured optimally and recommends out-of-office measurement (home or ambulatory) to confirm the diagnosis. A raised office value with a home average below 130/80 mm Hg is white coat hypertension, which is followed with yearly or opportunistic monitoring. Masked hypertension is the reverse: normal in the office but raised at home. Source: Hypertension Canada primary care guideline (CMAJ 2025;197:E549), Figure 2 diagnostic algorithm and out-of-office assessment recommendation.

Common mistake

Diagnosing hypertension from an office reading when out-of-office readings are normal.

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