American Board of Internal Medicine (ABIM) Certification Practice Exam

What average 24-hour ABPM measurement corresponds to a clinic blood pressure measurement of 130/80 mm Hg?

1. 120/75 mm Hg

2. 125/75 mm Hg

3. 130/80 mm Hg

4. 135/85 mm Hg

The correct answer is: 125/75 mm Hg

The average 24-hour Ambulatory Blood Pressure Monitoring (ABPM) measurement that corresponds to a clinic blood pressure reading of 130/80 mm Hg is typically lower due to the phenomenon known as "white coat syndrome," where patients often exhibit higher blood pressure readings in a clinical setting compared to those measured in a more relaxed, ambulatory environment. In practice, for a clinic reading of 130/80 mm Hg, a common expectation for the average ABPM would be a value lower than this, reflecting the soothing effect of being outside of a clinical setting. The average value of 125/75 mm Hg represents a reasonable estimate, aligning with clinical guidelines that suggest a range of around 10 to 15 mm Hg lower for daytime ABPM readings compared to office measurements. This understanding is crucial for effective hypertension management, as it helps clarify whether a patient's elevated clinic blood pressure may warrant further concern or if it is simply a reflection of their anxiety during medical visits. The remaining options do not appropriately reflect the expected lower average due to white coat phenomenon or other factors affecting blood pressure readings outside the clinic environment.