Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Doctor is my blood pressure OK?

Journal of Human Hypertension volume 32, pages 465–466 (2018)Cite this article

Subjects

When you have blood pressure (BP) checked at your doctor’s office, how do you know if it is normal or high? Well, it turns out that answering the question “Doctor, is my BP OK?” is complicated.

BP fluctuates throughout the day. Usually it is the highest in the morning, upon waking, which is one reason that strokes most commonly occur between 6 and 8 AM. BP falls as the day goes on, decreasing by 10–20% from daytime levels to sleep (known as nocturnal BP dipping). It decreases with rest and rises with activity, pain, or anxiety (leading to the “white coat effect” of high BP when a health care provider is present during a BP measurement). BP can also rise or fall for no reason at all.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Shimbo D, Abdalla M, Falzon L, Townsend RR, Muntner P. Role of ambulatory and home BP monitoring in clinical practice. Ann Intern Med. 2015;163:691–700.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Piper MA, Evans CV, Burda BU, Margolis KL, O’Connor E, Whitlock EP. Diagnostic and predictive accuracy of BP screening methods with consideration of rescreening intervals: a systematic review for the USPSTF. Ann Intern Med. 2015;162:192–204.

    Article  PubMed  Google Scholar 

  3. Myers MG. A proposed algorithm for diagnosing hypertension using automated office blood pressure measurement. J Hyptertens. 2010;28:703–8.

    Article  CAS  Google Scholar 

  4. Myers MG, Kaczorowski J, Paterson JM, Dolovich L, Tu K. Thresholds for diagnosing hypertension based on automated office blood pressure measurements and cardiovascular risk. Hypertension. 2015;66:489–95.

    Article  PubMed  CAS  Google Scholar 

  5. SPRINT Reseach Group, Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103–16.

    Article  CAS  Google Scholar 

  6. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for prevention, detection, evaluation and management of high BP in adults. J Am Coll Cardiol. 2017;S0735-1097:41519–1.

    Google Scholar 

  7. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental, occupational, and metabolic risks or cluster of risks 1990-2016; a systematic analysis for the Global Burden of Disease Study 2016. Lancet . 2017;390:1345–422.

    Article  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA

    Beverly B. Green

Authors
  1. Beverly B. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beverly B. Green.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Green, B.B. Doctor is my blood pressure OK?. J Hum Hypertens 32, 465–466 (2018). https://doi.org/10.1038/s41371-018-0067-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-018-0067-9

Search

Advanced search

Quick links