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1. A 45-year-old man comes to your clinic for a routine check-up. His blood
pressure (BP) is 142/92 mm Hg on two separate readings in the office. He
does not have any symptoms or comorbidities. You advise him to monitor his
BP at home for a week and return for a follow-up visit. What is the diagnostic
threshold for hypertension based on home BP monitoring (HBPM)?
A) 130/80 mm Hg
B) 135/85 mm Hg*
C) 140/90 mm Hg
D) 145/95 mm Hg
Rationale: According to the NICE guideline update 2019, the diagnostic
threshold for hypertension based on HBPM is 135/85 mm Hg or greater. The
threshold for office BP is 140/90 mm Hg or greater, and the threshold for 24-
hour ambulatory BP monitoring (ABPM) is 130/80 mm Hg or greater.
2. A 60-year-old woman with type 2 diabetes and chronic kidney disease has
been taking antihypertensive medication for several years. Her BP is well
controlled at 128/78 mm Hg in the office. However, she complains of feeling
dizzy and lightheaded when she stands up from a sitting position. You
measure her standing BP after 1 minute and find it to be 110/70 mm Hg.
What is the most likely explanation for this finding?
A) White coat hypertension
B) Masked hypertension
C) Postural hypotension*
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