Hypertension: What's new in diagnosis?

The direct and progressive relationship between diastolic blood pressure and incidence of stroke and coronary artery disease is beyond question. To reduce risk, screen patients regularly. Any patient who has a systolic blood pressure of 130 mm Hg or higher, or a diastolic pressure of 85 mm Hg or higher, requires follow-up or evaluation, lifestyle modification, and possibly drug therapy. Ambulatory blood pressure monitoring can help determine whether a patient has 'white coat' hypertension. To reduce error, at least 40 measurements should be made during the patient's waking hours. If the average ambulatory blood pressure is less than 132/83 mm Hg - regardless of how high the pressure spikes in your office-the patient probably does not require drug therapy.