Commentary: The prevalence of white-coat hypertension increases with age and previous studies have shown that cardiovascular (CV) outcomes of patients with white-coat hypertension are similar to that of normotensive individuals. This study suggests that WCH infers risk particularly in patients who are at elevated CV risk by virtue of other risk factors and who are older than age 60. In other groups, consistent with previous studies, WCH has essentially the same risk as normotensive individuals. For this reason, for patients with moderately elevated blood pressure and without target organ damage, the joint scientific statement from the American Heart Association and American Society of Hypertension recommends checking home blood pressure with a minimum of 12 readings taken over 7 days. According to AHA guidelines, home blood pressure readings should be performed twice a day, first thing in the morning and at night before going to sleep. Evening readings tend to be higher than morning readings. If the average is over 135/85, then a diagnosis of hypertension is confirmed and treatment can be started.¹ —Neil Skolnik, MD

1. Pickering TG, et al. Call to action on use and reimbursement for home blood pressure monitoring. A joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:10-29.