This recommendation places a relatively higher value on detecting a potential difference in BP status based on of ce versus out-of-of ce BP (Figure 4). In the judgment of the Work Group, the potential bene ts of additional information obtained from out-of-of ce BP measurements outweigh the additional costs and increased patient burden that these measurements impose. We suggest using an initial ABPM to supplement standardized of ce BP and HBPM for ongoing management of BP. Although ABPM may be the better measurement method, HBPM is more prac- tical for routine out-of-of ce assessment. HBPM may be particularly important for the management of BP when a clinic visit is not practical, for example, in the coronavirus disease 2019 (COVID-19) pandemic. For individuals not taking antihyper- tensive medication identi ed as having white-coat hyperten- sion, annual out-of-of ce BP assessments may be useful. For individuals taking antihypertensive medication, 1 week of daily HBPM prior to each of ce visit may be useful to complement standardized of ce BP for clinical management decisions. This is a weak recommendation according to GRADE, since there are no large RCTs comparing the effects of lower versus higher BP goals on clinical outcomes in adults that used out-of-of ce measurements to guide the BP intervention. Hence, the BP target using out-of-of ce measurements is unknown. Furthermore, it may not be feasible to implement ABPM and HBPM in many settings. Providers working in areas where ABPM is not available may choose to use HBPM instead of an initial ABPM procedure. Patients who nd ABPM and HBPM to be uncomfortable and inconvenient may prefer not to use such devices. Key information Balance of bene ts and harms. 