Home BP Measurement

1. Home BP monitoring can be used in the diagnosis of hypertension (Grade C).
2. The use of home BP monitoring on a regular basis should be considered for patients with hypertension, particularly those with:
   1. Diabetes mellitus (Grade D);
   2. Chronic kidney disease (Grade C);
   3. Suspected non-adherence (Grade D);
   4. Demonstrated white coat effect (Grade C);
   5. BP controlled in the office but not at home (masked hypertension) (Grade C).
3. When white coat hypertension is suggested by home BP monitoring, its presence should be confirmed by repeat home BP monitoring (see guideline 7 in this section) or ambulatory BP monitoring before treatment decisions are made (Grade D).
4. Patients should be advised to purchase and use only home BP monitoring devices that are appropriate for the individual and that have met standards of the Association for the Advancement of Medical Instrumentation, the most recent requirements of the British Hypertension Society protocol or the International Protocol for validation of automated BP measuring devices. Patients should be encouraged to use devices with data recording capabilities or automatic data transmission to increase the reliability of reported home BP monitoring. (Grade D).
5. Home SBP values ≥135 mmHg or DBP values ≥85 mmHg should be considered to be elevated and associated with an increased overall mortality risk (Grade C).
6. Health care professionals should ensure that patients who measure their BP at home have adequate training, and if necessary, repeat training in measuring their BP. Patients should be observed to determine that they measure BP correctly and should be given adequate information about interpreting these readings (Grade D).
7. Home BP monitoring for assessing white coat hypertension or sustained hypertension should be based on duplicate measures, morning and evening, for an initial 7-day period. First-day home BP values should not be considered (Grade D).