Het einde van de gewone praktijkbloeddrukmeting?

Van der Wel MC, Scherpbier-de Haan ND. The end of blood pressure measurements in general practice? Huisarts Wet 2015;58(2):70-3. Measurement errors and the white coat effect hinder the accurate measurement of blood pressure in general practice, and it is for this reason that protocol-based measurement of blood pressure at home and 24-hour measurements are incorporated into cardiovascular risk management. Disadvantages are the limited knowledge about whether measurements are performed and patient discomfort or hinder, respectively. Another limitation is that risk tables for cardiovascular risk management are based on manual office blood pressure measurements. Serial, automatic 30-minute blood pressure measurements reduce measurement errors and the white coat effect. The patient sits alone in a room and blood pressure is measured every 5 minutes, using a 24-hour monitor. Validation has shown that results obtained with this method are comparable to average values obtained with 24-hour monitoring and are more reproducible than traditional office blood pressure measurements. Thirty-minute office blood pressure measurement, protocol-based measurement at home, and 24-hour blood pressure monitoring are ways to detect the white coat effect.