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Editor's Correspondence |

Isolated Office Hypertension: Ambulatory BP Monitoring Is the Only Answer

Krishan L. Gupta, MD
Arch Intern Med. 2002;162(13):1526. doi:.
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The article by Grandi et al1 titled "Left Ventricular Changes in Isolated Office Hypertension [IOH]: A Blood Pressure [BP]–Matched Comparison With Normotension and Sustained Hypertension" clearly concludes that IOH, "also defined as white-coat hypertension," is not entirely a benign condition. The accompanying editorial by Dr Moser2 suggests that patients with IOH should be reevaluated over time, apparently in the office setting. However, since not all patients with IOH are noted to have sustained hypertension or left ventricular diastolic dysfunction, treating all patients with IOH for hypertension simply cannot be justified. It is estimated that between 25% and 50% of all patients with IOH have normal BP levels outside the physician's offices. Clearly, this population must not be labeled hypertensive.

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An algorithmic approach to the treatment of isolated office hypertension (IOH), also known as white-coat hypertension, is shown. BP indicates blood pressure.

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