1. A 45-year-old man comes to your clinic for a routine check-up. His blood

pressure (BP) is 142/92 mm Hg on two separate readings in the office. He

does not have any symptoms or comorbidities. You advise him to monitor his

BP at home for a week and return for a follow-up visit. What is the diagnostic

threshold for hypertension based on home BP monitoring (HBPM)?

A) 130/80 mm Hg

B) 135/85 mm Hg*

C) 140/90 mm Hg

D) 145/95 mm Hg

Rationale: According to the NICE guideline update 2019, the diagnostic

threshold for hypertension based on HBPM is 135/85 mm Hg or greater. The

threshold for office BP is 140/90 mm Hg or greater, and the threshold for 24-

hour ambulatory BP monitoring (ABPM) is 130/80 mm Hg or greater.

2. A 60-year-old woman with type 2 diabetes and chronic kidney disease has

been taking antihypertensive medication for several years. Her BP is well

controlled at 128/78 mm Hg in the office. However, she complains of feeling

dizzy and lightheaded when she stands up from a sitting position. You

measure her standing BP after 1 minute and find it to be 110/70 mm Hg.

What is the most likely explanation for this finding?

A) White coat hypertension

B) Masked hypertension

C) Postural hypotension*