American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the minimum blood pressure that an average 24-hour ABPM of 125/75 mm Hg can correspond to when monitoring clinic measurements?

1. 120/80 mm Hg

2. 130/80 mm Hg

3. 140/90 mm Hg

4. 135/85 mm Hg

The correct answer is: 130/80 mm Hg

In the context of blood pressure monitoring, an average 24-hour Ambulatory Blood Pressure Monitoring (ABPM) reading of 125/75 mm Hg signifies that the measurements taken over the full 24-hour period indicate a relatively normal blood pressure level. However, when correlating these values to office or clinic measurements, it's important to consider that clinic blood pressure readings can often yield higher results due to the white-coat effect or other factors. In general, the clinic blood pressure that corresponds to ABPM readings typically is noted to be higher than the averaged day-long readings obtained from ABPM. Therefore, a 24-hour ABPM average of 125/75 mm Hg could align with a clinic measurement in the range of 130/80 mm Hg. This represents a conservative yet realistic increase that accounts for potential variances encountered in a clinical setting. The chosen value aligns with this principle of how averages translate into clinical measurements, as it maintains a balance between normal ranges and the variability seen in clinical readings without categorizing the individual as hypertensive, which is defined at higher thresholds. The other options reflect either lower or unreasonably high estimations for average clinic measurements that are not consistent with the known relationship between 24-hour ABPM data and clinic