Harvard Heart Letter

Sporadic high blood pressure deserves attention

Different readings in the doctor's office and at home are cause for concern.

A single blood pressure reading, like the one made in your doctor's office, is merely a snapshot taken from an endlessly playing 24-hour movie. For some people, that one measurement is a good summary of the movie. For others, it's a poor reflection of their usual blood pressure.

As many as 20% of Americans have different blood pressure at home than they do in the doctor's office. Some have white-coat hypertension — high blood pressure in the doctor's office but normal pressure at home. Others have masked hypertension — normal blood pressure in the doctor's office but periods of high pressure at home, such as during episodes of stress or early in the morning when the effects of blood pressure medicine have worn off.

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