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ABPM Diagnostic Thresholds — EECC MCQ

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EasyHypertension & Preventive CardiologyABPM Diagnostic ThresholdsEECC

A 60-year-old man with newly diagnosed hypertension has his ABPM results reviewed. His 24-hour average BP is 142/88 mmHg with a daytime average of 148/92 mmHg and night-time average of 128/80 mmHg. What are the ABPM thresholds for diagnosing hypertension?

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Correct answer: C — ABPM confirms sustained hypertension using lower thresholds

The 2024 ESC Hypertension Guidelines define ABPM diagnostic thresholds that are LOWER than office BP thresholds (reflecting the absence of the white coat effect): (1) 24-hour average ≥130/80 mmHg; (2) daytime ≥135/85 mmHg; (3) night-time ≥120/70 mmHg. Any one abnormal threshold confirms hypertension. ABPM provides additional prognostic information beyond office BP: nocturnal BP, dipping pattern, BP variability, morning surge, and ambulatory arterial stiffness index. ABPM is the recommended out-of-office confirmation method (Class I) and is superior to office BP for predicting target organ damage and cardiovascular events. HBPM thresholds (≥135/85 mmHg) are the same as daytime ABPM thresholds.

Reference: ESC (2024): Guidelines for Hypertension: https://bnf.nice.org.uk/