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The use of ambulatory blood pressure monitoring to confirm a diagnosis of high blood pressure by primary-care physicians in Oregon

Carter, Brittany U.; Kaylor, Mary Beth

doi: 10.1097/MBP.0000000000000166
Clinical Methods and Pathophysiology

Background Hypertension is the most commonly diagnosed medical condition in the USA. Unfortunately, patients are misdiagnosed in primary care because of inaccurate office-based blood pressure measurements. Several US healthcare organizations currently recommend confirming an office-based hypertension diagnosis with ambulatory blood pressure monitoring to avoid overtreatment; however, its use for the purpose of confirming an office-based hypertension diagnosis is relatively unknown.

Methods This descriptive study surveyed 143 primary-care physicians in Oregon with regard to their current use of ambulatory blood pressure monitoring.

Results Nineteen percent of the physicians reported that they would use ambulatory blood pressure monitoring to confirm an office-based hypertension diagnosis, although over half had never ordered it. The most frequent indication for ordering ambulatory blood pressure monitoring was to investigate suspected white-coat hypertension (37.3%). In addition, many of the practices did not own an ambulatory blood pressure monitoring device (79.7%) and, therefore, had to refer patients to other clinics or departments for testing.

Conclusion Many primary-care physicians will need to change their current clinical practice to align with the shift toward a confirmation process for office-based hypertension diagnoses to improve population health.

Supplemental Digital Content is available in the text.

aKaiser Permanente Center for Health Research, Portland, Oregon

bCollege of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA

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Correspondence to Brittany U. Carter, MPH, Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97239, USA Tel: +1 503 335 3991; fax: +1 503 335 2424; e-mail:

Received October 1, 2015

Received in revised form October 23, 2015

Accepted November 6, 2015

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