Table 1.

Comparison of BP measurement techniques

ConsiderationManual Office BPAutomated Office BPHome BPAmbulatory BPCentral BP
DescriptionTraditional manual office BPOffice BP using oscillometric deviceMeasurement of BP in the home; typically using an oscillometric deviceAutomated measurement of BP over the course of 24 h; BP typically measured every 30 min during the day and nightMeasured using applanation tonometry of the carotid or radial artery or with cuff-based oscillometry at the brachial artery
Monitoring scheduleOffice visitOffice visitLong term24 h, Including nighttimeOffice visit
Patient education requiredNoNoYesYesNo
White coat effectLikelyReduced versus manual BPNoNoPossible
Availability in most physician officesYesYesNALimitedLimited
Assessment of nighttime BP and nocturnal dippingNoNoNoYesNo
Assessment of central hemodynamicsNoNoNoNoaYes
Evidence showing association with adverse outcomesStrongModerateModerateStrongModerate
Diagnosis thresholds for hypertension, mm Hg (ESH/ESC 2013, HCGC 2017)140/90b135/85c135/85Daytime: 135/85; nighttime: 120/70NA
Diagnosis thresholds for hypertension, mm Hg (ACC/AHA 2017)130/80 (Does not specify routine office BP versus automated office BP130/80dDaytime: 130/80d; nighttime: 110/65dNA
  • NA, not applicable; ESH/ESC, European Society of Hypertension/European Society of Cardiology Task Force; HCGC, Hypertension Canada Guidelines Committee; ACC/AHA, American College of Cardiology/American Heart Association Task Force.

  • a Some devices are capable of both 24-hour ambulatory BP monitoring and central pressure monitoring.

  • b The ESH/ESC guidelines do not specify routine office BP versus automated office BP.

  • c The HCGC guidelines specify a routine office BP threshold of 140/90 mm Hg and an automated office BP threshold of 135/85 mm Hg.

  • d Correspondent values to office BP of 130/80 mm Hg as noted in the ACC/AHA 2017 guidelines.